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Risk factors associated with intestinal necrosis in children with failed non-surgical reduction for intussusception

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Abstract

Background

Intestinal necrosis is the most serious complication of intussusception. The risk factors associated with intestinal necrosis in pediatric patients with intussusception have not been well characterized.

Objective

This study aimed to investigate the risk factors associated with intestinal necrosis in pediatric patients with failed non-surgical reduction for intussusception.

Methods

Hospitalized patients who failed the air-enema reduction for intussusception in the outpatient department and subsequently underwent surgery were retrospectively reviewed. All cases were categorized into two groups: intestinal necrosis group and non-intestinal necrosis group based on the surgical findings. Demographic and clinical features including the findings from the surgery were recorded and analyzed. Factors associated with intestinal necrosis were analyzed using univariate and multivariate unconditional logistic regression analyses.

Results

A total of 728 cases were included. Among them, 171 had intestinal necrosis at the time of surgery. The group with intestinal necrosis had a longer duration of symptom or length of illness (P = 0.000), and younger (P = 0.000) than the non-intestinal necrosis group. Complex/compound type of intussusceptions is more likely to have intestinal necrosis. Multivariate analysis showed that the presence of grossly bloody stool (OR = 2.12; 95% CI 1.19–3.76, P = 0.010) and duration of symptom (OR = 1.07; 95% CI 1.06–1.08, P = 0.000) were independent risk factors for intestinal necrosis in patients hospitalized for surgical reduction for intussusceptions.

Conclusion

At time of admission, the presence of bloody stools and duration of symptom are the important risk factors for developing intestinal necrosis for those patients who failed non-surgical reduction. The length of illness has the highest sensitivity and specificity to correlate with intestinal necrosis. This finding may suggest that we should take the intussusception cases that have the longer duration of symptom directly to operation room for reduction.

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Funding

The present work was supported in part by WenZhou Science & Technology Bureau Foundation (Grant #Y20150039 and #Y20150021).

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Authors and Affiliations

  1. Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China

    Hui-Ya Huang

  2. The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, 325027, China

    Xiao-Zhong Huang, Yi-Jiang Han, Li-Bin Zhu, Kai-Yu Huang, Jing Lin & Zhong-Rong Li

  3. Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA

    Jing Lin

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  1. Hui-Ya Huang
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  2. Xiao-Zhong Huang
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  5. Kai-Yu Huang
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Correspondence to Jing Lin or Zhong-Rong Li.

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The authors declare no conflict of interest.

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H.-Y. Huang and X.-Z. Huang contributed equally to the paper.

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Huang, HY., Huang, XZ., Han, YJ. et al. Risk factors associated with intestinal necrosis in children with failed non-surgical reduction for intussusception. Pediatr Surg Int 33, 575–580 (2017). https://doi.org/10.1007/s00383-017-4060-0

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  • DOI: https://doi.org/10.1007/s00383-017-4060-0

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