Park In Kyu, Cho Min Jeng
Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
Front Pediatr. 2021 Mar 31;9:651297. doi: 10.3389/fped.2021.651297. eCollection 2021.
The purpose of this study was to evaluate whether clinical findings in children with ileocolic intussusception differ based on age and duration of symptoms and to assess the clinical characteristics of diagnosed and undiagnosed patients to determine which symptoms make diagnosis more difficult. We reviewed 536 medical records of <15-year-old children diagnosed with ileocolic intussusception between 2008 and 2019. We divided the children into three categories according to age (<1 year, 1-2 years, and ≥2 years). The children were also divided into two groups based on whether symptoms lasted for more or <6 h. Diagnosed and undiagnosed children were assessed separately during for the initial evaluation. Following analysis of the three age groups, bloody stool, post-enema bloody stool, diarrhea, vomiting, poor oral intake, and lethargy were more frequent in children aged <1 year. In children aged ≥2 years, non-specific abdominal pain was more frequent and the undiagnosed rate was higher. Following analysis of the duration of symptoms, paroxysmal pain was significantly more frequent in the early group (<6 h), and bloody stool and fever were significantly more frequent in the late group (≥6 h). Nonspecific abdominal pain was more frequent and the door-to-diagnosis time was significantly longer in the undiagnosed group than in the diagnosed group. Clinical findings of ileocolic intussusception vary depending on the age and duration of symptoms. Younger children with paroxysmal pain, vomiting, bloody stool, poor oral intake, or lethargy should be suspected of having intussusception. In older children, non-specific abdominal pain without bloody stool may be a symptom of intussusception. Glycerin enema is helpful in diagnosing intussusception in children with no typical symptoms.
本研究的目的是评估回结肠套叠患儿的临床症状是否因年龄和症状持续时间而异，并评估已确诊和未确诊患者的临床特征，以确定哪些症状会使诊断更加困难。我们回顾了2008年至2019年间诊断为回结肠套叠的15岁以下儿童的536份病历。我们根据年龄（<1岁、1 - 2岁和≥2岁）将儿童分为三类。还根据症状持续时间是否超过或<6小时将儿童分为两组。在初始评估期间分别对已确诊和未确诊的儿童进行评估。对三个年龄组进行分析后发现，<1岁的儿童中便血、灌肠后便血、腹泻、呕吐、口服摄入量少和嗜睡更为常见。在≥2岁的儿童中，非特异性腹痛更为常见且未确诊率更高。对症状持续时间进行分析后发现，早期组（<6小时）阵发性疼痛明显更常见，晚期组（≥6小时）便血和发热明显更常见。未确诊组中非特异性腹痛更常见且从就诊到诊断的时间明显长于确诊组。回结肠套叠的临床症状因年龄和症状持续时间而异。出现阵发性疼痛、呕吐、便血、口服摄入量少或嗜睡的年幼儿童应怀疑患有套叠。在大龄儿童中，无便血的非特异性腹痛可能是套叠的症状。甘油灌肠有助于诊断无典型症状的儿童的套叠。
