Risk factors for recurrent intussusception after successful reduction in pediatric patients in a tertiary care hospital of Nepal: A prospective study. (April 2022)

• Record Type: Journal Article
• Authors: Adhikari, Shankar; Koirala, Dinesh Prasad; Pokhrel, Rameshwor Prasad; Dahal, Geha Raj; Kharel, Sanjeev; Neupane, Subita
• Is Part Of: Annals of medicine and surgery. Volume 76(2022)
• Publication Date: 2022-04
• Subjects: Intussusception -- Hydrostatic reduction -- Recurrence -- Risk factors; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.103427
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Background: Intussusception is defined as the invagination of one segment of intestine into another segment of intestine. It may recur because of persistence or return of some factor responsible for the primary intussusception. Various risk factors have been reported but still not well elucidated. Materials and methods: This is the prospective observational study. In this study, 78 patients, age <16 years with diagnosis of intussusception between June 2019 and April 2020 who had successful reduction with either hydrostatic reduction and/or operative reduction in Teaching Hospital were enrolled in the study. This is study of early recurrence as patients were followed up to a period of 1 month for recurrence of intussusception. The recurrent cases were thus identified and various variables were compared between recurrent and non-recurrent cases by univariable and multivariable analysis. Results: Among 78 patients, 13 patients (16.7%) had recurrent intussusception. In the univariable analysis model, the significant risk factors for recurrence of intussusception analyzed were duration of symptoms of 48 h or more, fever, blood in stool and palpable mass. While after multivariable analysis, we found that the significant risk factors for recurrence of intussusception were duration of symptoms ≥48 h (OR = 5.32, p-value = 0.047), Fever (OR = 17.32, p-value = 0.001), palpable mass (OR = 24.12, p-value = 0.017). Conclusion: Attention and awareness among pediatricians about these sonographic and clinical risk factors especially symptoms for recurrence are needed to minimize pre-hospital delay and identify patients in risk of recurrence. This ultimately helps to improve care for pediatric patients with recurrent intussusception. Highlights: Intussusception is a common abdominal emergency in infancy and childhood. Definitive or reliable risk factors for recurrence, other than anatomical features, have not been well elucidated. Duration of symptoms >24 h, fever and palpable mass are the risk factors.