Department of Surgery, Bowen University Iwo and Bowen University Teaching Hospital, Nigeria.
Department of Surgery, University of Medical Sciences and University of Medical Sciences Teaching Hospital Complex, Nigeria.
S Afr J Surg. 2020 Sep;58(3):138-142.
The outcome in infants and young children of intestinal obstruction due to intussusception is well documented in high-income countries. Our aim was to investigate the current pattern of presentation, management and outcome of childhood intussusception in a middle-income country using a multicentre approach.
Records of children managed for intussusception in three centres in South West Nigeria were retrospectively reviewed and analysed.
One hundred and ninety children managed for intussusception were analysed. The male-to-female ratio was 1.8:1. The median age was 7 months with a peak age incidence of 3-6 months. Peak incidence was recorded during the dry season. Passage of bloody stool, vomiting, abdominal pain and fever were the most common presenting features. Seventy-three (38.4%) of the patients presented with the classic triad. The median duration of symptoms was three days and only 19 (10.1%) patients presented in less than 24 hours. Ileocolic intussusception was the most common anatomic type, occurring in 166 (87.4%) patients, and was significantly associated with age. Twenty-two (56.4%) had successful hydrostatic reduction, while 165 (88.2%) required surgery. Forty (21.1%) patients suffered postoperative complications. Eleven (5.8%) of the patients died. The median duration of hospital stay was six days, and this correlated with the duration of symptoms and the length of hospital stay.
Delayed presentation is a persisting challenge in the management of childhood intussusception in Nigeria. Prompt referral to a paediatric surgeon may reduce the surgery rate, associated morbidity and the length of hospital stay.
在高收入国家，肠套叠导致的婴儿和幼儿肠梗阻的结果已有充分记录。我们的目的是通过多中心方法研究中低收入国家儿童肠套叠的当前表现、治疗和结果模式。
回顾性分析了尼日利亚西南部三个中心治疗肠套叠的儿童的记录并进行了分析。
共分析了 190 例接受肠套叠治疗的儿童。男女比例为 1.8:1。中位年龄为 7 个月，发病高峰为 3-6 个月。发病高峰出现在旱季。便血、呕吐、腹痛和发热是最常见的表现。73 例（38.4%）患者出现典型三联征。症状持续时间中位数为 3 天，只有 19 例（10.1%）患者在 24 小时内就诊。回盲型肠套叠是最常见的解剖类型，发生在 166 例（87.4%）患者中，与年龄显著相关。22 例（56.4%）患者成功进行水压复位，而 165 例（88.2%）患者需要手术。40 例（21.1%）患者术后发生并发症。11 例（5.8%）患者死亡。中位住院时间为 6 天，这与症状持续时间和住院时间相关。
在尼日利亚，儿童肠套叠的治疗中，延迟就诊仍然是一个持续存在的挑战。及时转诊给小儿外科医生可能会降低手术率、相关发病率和住院时间。
