Nonischemic intussusception in childhood.

The classical presentation of intussusception consisting of severe abdominal pain, bloody stool, and a palpable abdominal mass leads to the correct diagnosis in majority of the patients. However, an atypical presentation often results in a delayed diagnosis as is commonly seen in nonischemic intussusception. The nonischemic intussusception is a distinct clinical entity that is characterized by a long history of less severe symptoms commonly noticed in older children. The incidence of diarrhea in this group is higher than in the acute variety of intussusception. This variant of intussusception requires a high degree of suspicion for the diagnosis in atypical clinical presentation. The present study summarises our experience treating 31 such cases of nonischemic intussusception during a period of 25 years from 1966 to July 1990.

Nonspecific jejunitis--a challenging problem in children.

An acute enteric infection with the pathological feature of a severe necrotising jejunitis is an uncommon condition which mainly affects young people. It is characterized by severe abdominal pain of acute onset, copious bilious vomiting, and foul smelling loose stools containing blood. Exploration revealed varying degree of ischemic changes in the small bowel (mainly the upper jejunum) ranging from mucosal ulceration to frank gangrene of the bowel. The exact etiology is not known; the condition may be due to toxins produced by gram-negative bacilli or due to a localized allergic reaction. The disease had a progressive but self-limiting course. Mortality is around 40% and considerable morbidity continuing for 2-3 wk. Presentation bears similarity to Darmbrand of Germany, Pig-bel of New Guinea, and ischemic enteritis of Thailand.

Acute segmental necrotizing enteritis in children.

We studied a group of 22 children with an acute upper intestinal obstruction associated with segmental necrotizing enteritis, usually involving the jejunum. No similar cases were found in the literature.