Department of Pediatrics, SMS Medical College, Jaipur, Rajasthan, India.
Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India.
Indian J Pediatr. 2021 Mar;88(Suppl 1):131-137. doi: 10.1007/s12098-020-03601-8. Epub 2021 Jan 6.
To determine the clinical and epidemiological profile of Intussusception in children aged <2 y after introduction of rotavirus vaccine in Universal Immunization Programme of Rajasthan.
This was a hospital-based multi-centric surveillance study conducted at three tertiary care sentinel sites in Rajasthan over a period of 2 y. Children <2 y of age admitted with intussusception as per Brighton's criteria 1 were enrolled. Demographic details including age, sex, clinical presentation, diagnostic methods, duration of symptoms, mode of treatment, and complications were recorded and analyzed.
During the study period of 2 y, the authors identified 164 cases of intussusception based on level-1 Brighton's criteria. Median age at presentation was 7 mo [Interquartile range (IQR) 5-10 mo] with a male to female ratio of 2:1. Pain abdomen and blood stained stool were the commonest presenting complaints (88.4% and 81.7%, respectively). Commonest site of intussusception was Ileocolic (82.32%). Pathological lead point was identified in 18.9% cases. Distinct seasonality was observed as maximum cases of intussusception were detected in the months of Jan-March (34.1%). Surgical intervention was required in the 89.63% cases. The median time duration between onset of symptoms and admission at sentinel site was 2 d (IQR 1-3 d). Proportion of cases that required surgery increased as the time interval between onset of symptoms and admission increases.
Intussusception is a common surgical condition among children under-two years of age with majority of cases occurring during infancy. Case management is dependent primarily on time duration elapsed between symptoms onset and admission to tertiary care centre. Early case detection and timely referral may provide an opportunity to avoid surgical interventions.
在拉贾斯坦邦的普遍免疫计划中引入轮状病毒疫苗后，确定 2 岁以下儿童的肠套叠的临床和流行病学特征。
这是一项在拉贾斯坦邦三个三级保健哨点进行的基于医院的多中心监测研究，持续时间为 2 年。根据布莱顿标准 1 纳入因肠套叠而入院的年龄<2 岁的儿童。记录并分析人口统计学详细信息，包括年龄、性别、临床表现、诊断方法、症状持续时间、治疗方式和并发症。
在 2 年的研究期间，作者根据一级布莱顿标准确定了 164 例肠套叠病例。中位发病年龄为 7 个月[四分位数间距（IQR）为 5-10 个月]，男女比例为 2:1。腹痛和血便为最常见的症状（分别为 88.4%和 81.7%）。最常见的肠套叠部位是回盲部（82.32%）。18.9%的病例发现了病理性铅点。观察到明显的季节性，1 月至 3 月（34.1%）最多。89.63%的病例需要手术干预。症状发作和在哨点医院入院之间的中位数时间间隔为 2 天（IQR 1-3 天）。随着症状发作和入院之间的时间间隔增加，需要手术的病例比例增加。
肠套叠是 2 岁以下儿童常见的外科疾病，大多数病例发生在婴儿期。病例管理主要取决于症状发作和转诊至三级保健中心之间的时间间隔。早期发现病例并及时转诊可能有机会避免手术干预。
