Acute intussusception in childhood

ABSTRACT

Twenty eight cases of acute intussusception in childhood are described. A total mortality of 14 percent and a post-operative mortality of 12 percent indicates the need for earlier diagnosis and improvements in surgical management. In only 9 cases was there a classical clinical picture and in 8 of these, the tumour remained in the right half of the colon with normal peritoneal fixation. Misleading a typical symptoms commonly occurred when the tumour had reached the left half of the colon and rectum and in all of these the right half of the colon was llax and pendulous. These cases had a variable incidence of pain, pyrexia, vomiting, diarrhoea and of blood in the stools, making it important to differentiate intussusception from infective gastro-enteritis in infancy and to recognise that intussusception may be a complication or a sequel of infective gastro-enteritis. Surgical reduction and methods of resection are discussed. The importance of careful pre-operative resuscitation and of post-operative care is stressed and a plea, based on results elsewhere, is made for the co-operation of paediatrician, surgeon, radiologist and anaesthetist in the management of these cases (AU)