Background: The likelihood of a lead point as the cause of ileocolic intussusception increases as children get older.
This study looks at whether a different management strategy should be employed in older patients.
Methods: 7 year multi-institutional retrospective study of intussusception in patients aged b12 years.
Results: Ileocolic intussusception with complete data was found in 153 patients: 109 0–2 years,343–5 years, and
10 6–12 years, respectively. Bloody stools occurred in 42/143 of 0–5 years and 0/10 of 6–12 years, p b 0.001. Combined
hydrostatic and/or surgical reduction was successful in 113/143 0–5 year olds vs 5/10 6–12 year olds,
p b 0.001. Enemas were safe but reduced only 1 patient over age 5. Resections were required in 29 patients
(15 idiopathic, 14 lead points). Lead points were found in 4/109 children under 3 years, in 5/34 aged 3–5 years
and 5/10 aged 6–12 years (p=0.04 vs 3–5 years and p b0.001 vs 0–5 years). Lead points consisted of 7 Meckel’s
diverticula and 7 others.
Conclusion: Children older than 5 years are much more likely to have a pathologic lead point and early surgical
intervention should be considered. In this study, enema reduction was safe but minimally beneficial in this
age group
Background: The likelihood of a lead point as the cause of ileocolic intussusception increases as children get older.This study looks at whether a different management strategy should be employed in older patients.Methods: 7 year multi-institutional retrospective study of intussusception in patients aged b12 years.Results: Ileocolic intussusception with complete data was found in 153 patients: 109 0–2 years,343–5 years, and10 6–12 years, respectively. Bloody stools occurred in 42/143 of 0–5 years and 0/10 of 6–12 years, p b 0.001. Combinedhydrostatic and/or surgical reduction was successful in 113/143 0–5 year olds vs 5/10 6–12 year olds,p b 0.001. Enemas were safe but reduced only 1 patient over age 5. Resections were required in 29 patients(15 idiopathic, 14 lead points). Lead points were found in 4/109 children under 3 years, in 5/34 aged 3–5 yearsand 5/10 aged 6–12 years (p=0.04 vs 3–5 years and p b0.001 vs 0–5 years). Lead points consisted of 7 Meckel’sdiverticula and 7 others.Conclusion: Children older than 5 years are much more likely to have a pathologic lead point and early surgicalintervention should be considered. In this study, enema reduction was safe but minimally beneficial in thisage group
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