Skip to main content

Intussusception in infants younger than 3 months: a single center’s experience

Abstract

Background

The diagnosis and treatment of intussusception is often confusing in infants aged younger than 3 months. This study aimed to discuss the particularity of diagnosis and treatment of intussusception in this age group.

Methods

From April 1983 to June 2008, 39 infants aged 3 months or younger who had been diagnosed with intussusception were treated and their clinical data were analyzed retrospectively.

Results

Of the 39 infants (29 boys and 10 girls), ages ranged from 12 hours to 3 months, with a mean age of 52.6 days. The duration from onset to admission ranged from 7 to 142 hours (mean 39.6 hours). Three infants had intrauterine intussusception and 36 postnatal intussusception. The 3 infants with intrauterine intussusception had typical presentations of complete ileus after birth. Gap type ileal atresia was found in surgery in 2 of the 3 infants and primary anatomosis was performed therapeutically. The other infant was found to have ileal separation and a patent proximal end with diffused meconium peritonitis. The patient died 2 days after primary anastomosis. Most infants with postnatal intussusception had two or more manifestations of the tetralogy, namely intermittent screaming, vomiting, bloody stool, and abdominal mass. In 23 infants who underwent pneumatic reduction, 17 had a successful reduction and 6 converted to open surgery. Surgery was indicated for 19 infants, with maneuver procedure in 14. Meckel’s diverticulum was noted as a leading cause in 2 infants, ileal duplication in 1 with necrosis of intussusceptum, and primary intussusception with lead point necrosis in 2. The 5 infants, on whom segmental resection was performed, underwent primary anastomosis. All infants with postnatal intussusception had a smooth recovery.

Conclusions

Infants aged 3 months or younger may suffer from intussusception and most of them present with typical symptoms. Early diagnosis and treatment are needed for a good prognosis. Intrauterine intussusception may be an etiological factor for ileal atresia.

This is a preview of subscription content, access via your institution.

References

  1. Vestergaard H, Westergaard T, Wohlfahrt J, Pipper C, Melbye M. Association between intussusception and tonsil disease in childhood. Epidemiology 2008;19:71–74.

    Article  PubMed  Google Scholar 

  2. Huppertz HI, Soriano-Gabarró M, Grimprel E, Franco E, Mezner Z, Desselberger U, et al. Intussusception among young children in Europe. Pediatr Infect Dis J 2006;25(1 Suppl): S22–29.

    PubMed  Google Scholar 

  3. Tate JE, Simonsen L, Viboud C, Steiner C, Patel MM, Curns AT, et al. Trends in intussusception hospitalizations among US infants, 1993-2004: implications for monitoring the safety of the new rotavirus vaccination program. Pediatrics 2008;121: e1125–1132.

    Article  PubMed  Google Scholar 

  4. Munden MM, Bruzzi JF, Coley BD, Munden RF. Sonography of pediatric small-bowel intussusception: differentiating surgical from nonsurgical cases. AJR Am J Roentgenol 2007; 188:275–279.

    Article  PubMed  Google Scholar 

  5. Fischer TK, Bihrmann K, Perch M, Koch A, Wohlfahrt J, Kåre M, et al. Intussusception in early childhood: a cohort study of 1.7 million children. Pediatrics 2004;114:782–785.

    Article  PubMed  Google Scholar 

  6. Newman J, Schuh S. Intussusception in babies under 4 months of age. CMAJ 1987;136:266–269.

    CAS  PubMed  Google Scholar 

  7. Harrington L, Connolly B, Hu X, Wesson DE, Babyn P, Schuh S. Ultrasonographic and clinical predictors of intussusception. J Pediatr 1998;132:836–839.

    Article  CAS  PubMed  Google Scholar 

  8. Ko HS, Schenk JP, Tröger J, Rohrschneider WK. Current radiological management of intussusception in children. Eur Radiol 2007;17:2411–2421.

    Article  PubMed  Google Scholar 

  9. Justice FA, de Campo M, Liem NT, Son TN, Ninh TP, Bines JE. Accuracy of ultrasonography for the diagnosis of intussusception in infants in Vietnam. Pediatr Radiol 2007;37:195–199.

    Article  PubMed  Google Scholar 

  10. Ramachandran P, Gupta A, Vincent P, Sridharan S. Air enema for intussusception: is predicting the outcome important? Pediatr Surg Int 2008;24:311–313.

    Article  CAS  PubMed  Google Scholar 

  11. Kaiser AD, Applegate KE, Ladd AP. Current success in the treatment of intussusception in children. Surgery 2007;142:469–477.

    Article  PubMed  Google Scholar 

  12. Zulfiqar MA, Noryati M, Hamzaini AH, Thambidorai CR. Pneumatic reduction of intussusception using equipment readily available in the hospital. Med J Malaysia 2006;61:199–203.

    CAS  PubMed  Google Scholar 

  13. Fragoso AC, Campos M, Tavares C, Costa-Pereira A, Estevão-Costa J. Pneumatic reduction of childhood intussusception. Is prediction of failure important? J Pediatr Surg 2007;42: 1504–1508.

    Article  PubMed  Google Scholar 

  14. Blanch AJ, Perel SB, Acworth JP. Paediatric intussusception: epidemiology and outcome. Emerg Med Australas 2007;19: 45–50.

    Article  PubMed  Google Scholar 

  15. Blakelock RT, Beasley SW. The clinical implications of nonidiopathic intussusception. Pediatr Surg Int 1998;14:163–167.

    Article  CAS  PubMed  Google Scholar 

  16. Li L, Tong R. Early diagnosis of small intestinal intussusception in neonates. Chin J Neonatol 2001;16:222.

    Google Scholar 

  17. Chua JH, Chui CH, Jacobsen AS. Role of surgery in the era of highly successful air enema reduction of intussusception. Asian J Surg 2006;29:267–273.

    PubMed  Article  Google Scholar 

  18. Pomerantz B, Anupindi S, Wales PW, Doody DP, Masiakos PT. Radiographic reduction of intussusception in patients with cystic fibrosis. Pediatr Surg Int 2007;23:763–765.

    Article  PubMed  Google Scholar 

  19. Simanovsky N, Hiller N, Koplewitz BZ, Eliahou R, Udassin R. Is non-operative intussusception reduction effective in older children? Ten-year experience in a university affiliated medical center. Pediatr Surg Int 2007;23:261–264.

    Article  PubMed  Google Scholar 

  20. Saxena AK, Seebacher U, Bernhardt C, Höllwarth ME. Small bowel intussusceptions: issues and controversies related to pneumatic reduction and surgical approach. Acta Paediatr 2007;96:1651–1654.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Yun-Man Tang.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Kong, FT., Liu, WY., Tang, YM. et al. Intussusception in infants younger than 3 months: a single center’s experience. World J Pediatr 6, 55–59 (2010). https://doi.org/10.1007/s12519-010-0007-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12519-010-0007-4

Key words

  • diagnosis
  • infant
  • intussusception
  • neonate
  • pneumatic reduction
  • treatment