Dawod S T, Osundwa V M
Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar.
Ann Trop Paediatr. 1992;12(1):121-6. doi: 10.1080/02724936.1992.11747555.
Intussusception is one of the leading causes of bowel obstruction in early infancy and childhood. From 1984-1989, 67 patients under 2 years of age with intussusception were diagnosed and treated in our institution. There were 48 boys and 19 girls ranging in age from 2 months to 2 years with a mean of 7.4 months. Presenting symptoms and signs included abdominal pain (96%), vomiting (93%), rectal bleeding (60%) and a palpable mass (67%). Symptoms and signs were present for less than 24 hours in about 80% of cases. Most of the intussusceptions were of the ileocolic type (75%). The overall success rate of hydrostatic barium enema reduction was 49%. The highest rate of reduction by enema was among patients between 9 and 16 months of age (83%). The success rate of barium enema reduction was negligible after 24 hours of cardinal symptoms. Five children underwent surgical exploration without contrast studies because of delayed presentation and signs of an acute abdomen. A pathological lead point was found in only four cases, the commonest being Meckel's diverticulum. The average length of hospitalization was 2.57 days after barium enema reduction and 7.55 days after surgical reduction. There were no deaths. There was no case of perforation during enema reduction. Three children had recurrence within 3 months of initial presentation. The best outcome is associated with early diagnosis and barium enema reduction, or selected surgical intervention when indicated.
肠套叠是婴幼儿期肠梗阻的主要病因之一。1984年至1989年，我院诊断并治疗了67例2岁以下的肠套叠患儿。其中男48例，女19例，年龄从2个月至2岁不等，平均年龄为7.4个月。主要症状和体征包括腹痛（96%）、呕吐（93%）、直肠出血（60%）及可触及肿块（67%）。约80%的病例症状和体征持续时间不到24小时。大多数肠套叠为回结肠型（75%）。水压灌肠复位的总体成功率为49%。灌肠复位率最高的是9至16个月的患儿（83%）。主要症状出现24小时后，钡剂灌肠复位成功率可忽略不计。5例患儿因就诊延迟及急腹症体征未行造影检查而接受了手术探查。仅4例发现病理性套入点，最常见的是梅克尔憩室。钡剂灌肠复位后平均住院时间为2.57天，手术复位后为7.55天。无死亡病例。灌肠复位期间无穿孔病例。3例患儿在首次发病后3个月内复发。最佳治疗效果与早期诊断及钡剂灌肠复位或在有指征时选择手术干预有关。
