Introduction: Acute intestinal intussusception is a medical-surgical emergency. It is the main etiology of intestinal obstructions in infants. Its diagnosis is essentially clinical in its typical form with ultrasound confirmation. Care still remains problematic in developing countries where delay in care impacts morbidity and mortality. Our work aims to evaluate the epidemiological, clinical, diagnostic and therapeutic aspects of acute intestinal intussusception. Materials and Method: It was a 3-year retrospective and descriptive study from January 1, 2022 to December 31, 2024, including patients aged 0 to 15 years operated on for acute intestinal intussusception in the pediatric surgery department at Nianankoro Fomba Hospital in Segou. Results: We recorded 40 cases, representing an annual frequency of 13.3 cases. The average age was 2 years 5 months. There was a male predominance (24 cases). The sex ratio was 1.5. The average consultation time was 3.2 days. Thirty percent (30%) of patients had an altered general condition. The functional signs were dominated by vomiting (87%), paroxysmal cries (62.5%), and rectal bleeding (52.5%). The classic triad was present in 40% of cases. The intussusception sausage was palpable at 57.5% and prolapsed through the anus at 7.5%. Abdominal ultrasound was performed in 72.5% of cases. The treatment was surgical for all patients. The ileo-colic form (ileo-caeco-colic and transvalvular ileo-colic) represented 75% of cases. Manual desinvagination was performed in 65%, and resection-anastomosis in 35%. Postoperative complications were the abscess of the surgical site in 3 cases, including a case of recurrence of intussusception on day 6, then an eventration at 1 month. The average length of hospitalization was 6.6 days. Conclusion: The management of acute intestinal intussusception remains a challenge in our context. Improving your prognosis requires early diagnosis and treatment.
References
[1]
Bines, J.E., Ivanoff, B., Justice, F. and Mulholland, K. (2004) Clinical Case Definition for the Diagnosis of Acute Intussusception. JournalofPediatricGastroenterologyandNutrition, 39, 511-518. https://doi.org/10.1002/j.1536-4801.2004.tb00900.x
[2]
Ondhia, M.N., Al-Mutawa, Y., Harave, S. and Losty, P.D. (2020) Intussusception: A 14-Year Experience at a UK Tertiary Referral Centre. Journal of Pediatric Surgery, 55, 1570-1573. https://doi.org/10.1016/j.jpedsurg.2019.07.022
Buettcher, M., Baer, G., Bonhoeffer, J., Schaad, U.B. and Heininger, U. (2007) Three-year Surveillance of Intussusception in Children in Switzerland. Pediatrics, 120, 473-480. https://doi.org/10.1542/peds.2007-0035
[5]
Harrington, L., Connolly, B., Hu, X., Wesson, D.E., Babyn, P. and Schuh, S. (1998) Ultrasonographic and Clinical Predictors of Intussusception. TheJournalofPediatrics, 132, 836-839. https://doi.org/10.1016/s0022-3476(98)70314-2
[6]
Jenke, A.C., Klaaßen‐Mielke, R., Zilbauer, M., Heininger, U., Trampisch, H. and Wirth, S. (2011) Intussusception: Incidence and Treatment—Insights from the Nationwide German Surveillance. JournalofPediatricGastroenterologyandNutrition, 52, 446-451. https://doi.org/10.1097/mpg.0b013e31820e1bec
[7]
Pracros, J.P., Louis, D., Tran-Minh, V.A., etal. (1989) Invagination Intestinale aiguë du nourrisson et de l’enfant. Elsevier.
[8]
Daneman, A. and Navarro, O. (2003) Intussusception: Part 1: A Review of Diagnostic Approaches. PediatricRadiology, 33, 79-85. https://doi.org/10.1007/s00247-002-0832-2
[9]
Hryhorczuk, A.L. and Strouse, P.J. (2009) Validation of US as a First-Line Diagnostic Test for Assessment of Pediatric Ileocolic Intussusception. PediatricRadiology, 39, 1075-1079. https://doi.org/10.1007/s00247-009-1353-z
[10]
Bucher, B.T., Hall, B.L., Warner, B.W. and Keller, M.S. (2011) Intussusception in Children: Cost-Effectiveness of Ultrasound vs Diagnostic Contrast Enema. JournalofPediatricSurgery, 46, 1099-1105. https://doi.org/10.1016/j.jpedsurg.2011.03.034
[11]
Sargent, M.A., Babyn, P. and Alton, D.J. (1994) Plain Abdominal Radiogrophy in Suspected Intussusception: A Reassessment. PediatricRadiology, 24, 17-20. https://doi.org/10.1007/bf02017652
[12]
Kaiser, A.D., Applegate, K.E. and Ladd, A.P. (2007) Current Success in the Treatment of Intussusception in Children. Surgery, 142, 469-477. https://doi.org/10.1016/j.surg.2007.07.015
[13]
Mouafo Tambo, F.F. and Andze, O.G. (2009) Les invaginations intestinales aigues du nourrisson et de l’enfant en milieu africain: Intérêt d’un diagnostic précoce. Mali Medical, 24, 46-49.
[14]
Rakotoarisoa, B., Rabarijaona, M. and Zafit, A. (2001) Invagination intestinale aiguë du nourrisson à propos de 22 cas traités chirurgicalement dans le service de chirurgie pédiatrique au CHU d’Antananarivo. Médecined’AfriqueNoire, 48, 358-362.
[15]
Amadou, I. (2003) Invagination intestinale aiguë de l’enfant à propos de 65 cas traités chirurgicalement dans les services de chirurgie générale et pédiatrique du CHU Gabriel Toure. Université des Sciences, des Techniques et des Technologies de Bamako.
[16]
Benmansour, O. (2009) Invagination intestinale aiguë chez l’enfant et le nourrisson à l’hôpital provincial de Tanger. Thèse de Médecine, Université Mohammed 5 de Rabat.
[17]
de Lamber, G., Guérin, F., Franchi-Abella, S., Boubnova, J. and Martelli, H. (2015) Invagination intestinale aiguë du nourrisson et de l’enfant. Journal de Pédiatrie et de Puériculture, 28, 118-130. https://doi.org/10.1016/j.jpp.2015.04.001
[18]
Khen-Dunlop, N. (2020) L’invagination intestinale aiguë. JournaldePédiatrieetdePuériculture, 33, 221-227. https://doi.org/10.1016/j.jpp.2020.06.006
[19]
Weihmiller, S.N., Monuteaux, M.C. and Bachur, R.G. (2012) Ability of Pediatric Physicians to Judge the Likelihood of Intussusception. PediatricEmergencyCare, 28, 136-140. https://doi.org/10.1097/pec.0b013e3182442db1
[20]
Porter, H.J., Padfield, C.J., Peres, L.C., Hirschowitz, L. and Berry, P.J. (1993) Adenovirus and Intranuclear Inclusions in Appendices in Intussusception. JournalofClinicalPathology, 46, 154-158. https://doi.org/10.1136/jcp.46.2.154
[21]
Serayssol, C., Abbo, O., Mouttalib, S., Claudet, I., Labarre, D., Galinier, P., etal. (2014) Invagination intestinale aiguë du nourrisson et de l’enfant: Peut-on encore parler de prédominance automno-hivernale? Étude épidémiologique sur 10 ans. ArchivesdePédiatrie, 21, 476-482. https://doi.org/10.1016/j.arcped.2014.02.016
[22]
Bines, J.E., Liem, N.T., Justice, F.A., Son, T.N., Kirkwood, C.D., de Campo, M., etal. (2006) Risk Factors for Intussusception in Infants in Vietnam and Australia: Adenovirus Implicated, but Not Rotavirus. TheJournalofPediatrics, 149, 452-460.E1. https://doi.org/10.1016/j.jpeds.2006.04.010
[23]
Saida, M. (2011) Invagination intestinale du nourrisson et de l’enfant au service des urgences chirurgicales pédiatriques Hôpital d’enfants-Rabat (A propos de 40 cas). Thèse Médecine, Universitaire Hassan II.
[24]
Saleem, M.M., Al-Momani, H. and Abu Khalaf, M. (2008) Intussusception: Jordan University Hospital Experience. Hepatogastroenterology, 55, 1356-1359.
[25]
Klein, E.J., Kapoor, D. and Shugerman, R.P. (2004) The Diagnosis of Intussusception. ClinicalPediatrics, 43, 343-347. https://doi.org/10.1177/000992280404300405
[26]
Simanovsky, N., Hiller, N., Koplewitz, B.Z., Eliahou, R. and Udassin, R. (2006) Is Non-Operative Intussusception Reduction Effective in Older Children? Ten-Year Experience in a University Affiliated Medical Center. PediatricSurgeryInternational, 23, 261-264. https://doi.org/10.1007/s00383-006-1838-x
[27]
Justice, F.A., Auldist, A.W. and Bines, J.E. (2006) Intussusception: Trends in Clinical Presentation and Management. Journal of Gastroenterology and Hepatology, 21, 842-846. https://doi.org/10.1111/j.1440-1746.2005.04031.x
[28]
Grapin C. (2004) Invagination intestinale aiguë: Décoder les formes trompeuses. La Revue du Praticien, 18, 285-288.
[29]
Ugwu, B.T., Legbo, J.N., Dakum, N.K., Yiltok, S.J., Mbah, N. and Uba, F.A. (2000) Childhood Intussusception: A 9-Year Review. Annals of Tropical Paediatrics, 20, 131-135. https://doi.org/10.1080/02724936.2000.11748122
[30]
Yadav, K., Patel, R.V., Mitra, S.K., etal. (1986) Intussusception in Infancy and Childhood. Indian Journal of Pediatrics, 23, 113-120.
[31]
Ramachandran, P., Vincent, P., Prabhu, S. and Sridharan, S. (2006) Rectal Prolapse of Intussusception—A Single Institution’s Experience. EuropeanJournalofPediatricSurgery, 16, 420-422. https://doi.org/10.1055/s-2006-924732
[32]
Carbonneil, C. (2009) Principales indications et «non-indications» de la radiographie de l’abdomen sans préparation. HAS. https://www.has-sante.fr/
[33]
del-Pozo, G., Albillos, J.C. and Tejedor, D. (1996) Intussusception: US Findings with Pathologic Correlation—The Crescent-in-Doughnut Sign. Radiology, 199, 688-692. https://doi.org/10.1148/radiology.199.3.8637988
[34]
Khorana, J., Singhavejsakul, J., Ukarapol, N., Laohapensang, M., Siriwongmongkol, J. and Patumanond, J. (2016) Prognostic Indicators for Failed Nonsurgical Reduction of Intussusception. TherapeuticsandClinicalRiskManagement, 12, 1231-1237. https://doi.org/10.2147/tcrm.s109785
[35]
Strouse, P.J., DiPietro, M.A. and Saez, F. (2003) Transient Small-Bowel Intussusception in Children on CT. PediatricRadiology, 33, 316-320. https://doi.org/10.1007/s00247-003-0870-4
[36]
Stringer, M.D., Pledger, G. and Drake, D.P. (1992) Childhood Deaths from Intussusception in England and Wales, 1984-9. BMJ, 304, 737-739. https://doi.org/10.1136/bmj.304.6829.737
[37]
de Lamber, G., Guérin, F., Franchi-Abella, S., Boubnova, J. and Martelli, H. (2015) Invagination intestinale aiguë du nourrisson et de l’enfant. JournaldePédiatrieetdePuériculture, 28, 118-130. https://doi.org/10.1016/j.jpp.2015.04.001