Routine Surgical Intervention for Childhood Intussusception in a Developing Country

ABSTRACT

Objective/Purpose: We aim to determine the basis for the routine surgical treatment of intussusception in southeast Nigeria. Methods: We analyzed 71 children operated for intussusception between June 1998 and May 2006 at the University of Nigeria Teaching Hospital Enugu; southeastern Nigeria. Results: The median age at presentation was 6 months (range 3 months to 7 years); and the average duration from onset to presentation 3.2 days (range 4 hours to 7 days). Forty-six (64.8) had ileocolic intussusception; 7 (9.9) colocolic; and 5 (7.0) ileoileal. In 31 (43.7); there was no identifiable cause; while mesenteric lymphadenopathy and inflamed Peyer's patches were noted in 37 (52.1); and polyp in 3 (4.2). Manual reduction was successful in 39 (55); while 32 (45) required bowel resection for gangrene; or irreducibility. After average follow up of 9.7 months (range 4-22 months) there was no recurrence; but overall mortality was 6 (8.5) from septicemia. Late presentation; dearth of facilities and trained manpower; and lack of multidisciplinary collaboration may contribute to the regular surgical treatment. Conclusion: Intussusception in our setting is characterized by late presentation; high rate of bowel resection; and high mortality. Surgery may remain our main stay of treatment until deficiencies in time to diagnosis; specialized facilities; and personnel improvement