Abstract
Ultrasonography (US) was used to study intussusceptions prospectively at Kiyama Hospital in 1999 and 2000 under the classification of small bowel intussusception (SBI) and large bowel or ileo-ileo-colic intussusception (LBI). The clinical features, management, outcome and etiology were analyzed. All LBIs and SBIs with ischemic symptoms and SBIs complicated by LBI were treated by enema reduction, whereas SBIs considered to be nonischemic were observed. SBI was seen in 21 patients with a mean age of 62.6±31.2 months. Four cases (19.0%) were diagnosed during the course of LBI. US showed mesenteric lymphoid hyperplasia in 15 (71.4%). Hydrostatic enema reduction was successful in 9/9, and SBI reduced naturally in the other 12 (benign SBI). LBI occurred in 38 patients with a mean age of 27.8±21.2 months. Mesenteric lymphoid hyperplasia was observed in 29 (76.3%). Hydrostatic enema reduction was successful in 37/38. SBI occurs more frequently and in a wider age group than previously considered. Many SBIs reduced naturally, suggesting that they were only transient invagination phenomena and should be called benign SBI. The frequent association of SBI with LBI and also the frequent association of mesenteric lymphoid hyperplasia with both SBI and LBI seem the key to the pathophysiology of intussusception.
References
Navarro O, Dugougeat F, Kornecki A, Shukett B, Alton DJ, Daneman A (2000) The impact of imaging in the management of intussusception owing to pathologic lead points in children. A review of 43 cases. Pediatr Radiol 30:594–603
Jequier S, Argyropoulou M, Bugmann P (1995) Ultrasonography of jejunal intussusception in children. Can Assoc Radiol J 46:285–290
Staatz G, Alzen G, Heimann G (1998) Darminfektion, die haufigste invaginationsursache im kindesalter: Ergebnisse einer 10 jahrigen klinischen studie. Klin Padiatr 210:61–64
Doi O, Kiyama T, Sato A, Okafuji T, Konohana A, Kurosaka F, Yamada K, Okamoto Y (1995) Enema reduction of intussusception with a small dose of iopamidol may have advantages over barium. Pediatr Surg Int 10:332–334
Wang GD, Liu SJ (1988) Enema reduction of intussusception by hydrostatic pressure under ultrasound guidance: a report of 377 cases. J Pediatr Surg 23:814–818
Bell TM, Steyn JH (1962) Viruses in lymph nodes of children with mesenteric adenitis and intussusception. Br Med J 15:700–702
Hsu HY, Kao CL, Huang LM, Ni YH, Lai HS, Lin FY, Chang MH (1998) Viral etiology of intussusception in Taiwanese childhood. Pediatr Infect Dis J 17:893–898
Nakagomi T (2000) Rotavirus infection and intussusception: a view from retrospect. Microbiol Immunol 44:619–628
Koo JW, Cho CR, Cha SJ, Chung CY (1996) Intussusception associated with Yersinia pseudotuberculosis infection. Acta Paediatr 85:1253–1255
Kornecki A, Daneman A, Navarro O, Connolly B, Manson D, Alton DJ (2000) Spontaneous reduction of intussusception: clinical spectrum, management and outcome. Pediatr Radiol 30:58–63
Mushtaq N, Marven S, Walker J, Puntis JWL, Rudolf M, Stringer MD (1999) Small bowel intussusception in celiac disease. J Pediatr Surg 34:1833–1835
Ko SF, Lee TY, Ng SH, Wan WL, Chen MC, Tiao MM, Liang CD, Shieh CS, Chuang JH ( 2002) Small bowel intussusception in symptomatic pediatric patients: experiences with 19 surgically proven cases. World J Surg 26:438–443
Ong NT, Beasley SW (1990) Progression of intussusception. J Pediatr Surg 25:644–646
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The authors thank Masaru Komazawa, MD, PhD, Director of the Komazawa Children’s Clinic, for editorial assistance.
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Doi, O., Aoyama, K. & Hutson, J.M. Twenty-one cases of small bowel intussusception: the pathophysiology of idiopathic intussusception and the concept of benign small bowel intussusception. Ped Surgery Int 20, 140–143 (2004). https://doi.org/10.1007/s00383-003-1055-9
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DOI: https://doi.org/10.1007/s00383-003-1055-9