Management Outcome of Infancy and Childhood Intussusception in Rajshahi Medical College Hospital - A Prospective Study

Abstract

Background: Intussusception is one of the major causes of bowel obstruction in infancy and childhood. Proper diagnosis and effective management have significantly reduced its mortality and morbidity in developed country.
Aim: To document the mode of presentation and treatment outcome of Intussusception at Rajshahi Medical College Hospital.
Patients and Methods: Thirty three consecutive cases of this condition seen at paediatric surgical ward over one year period were prospectively studied. Details of symptoms and signs, pre-hospital care, treatment and outcome were documented.
Result: The triad of abdominal pain, bloody mucoid stools and palpable abdominal mass was seen in 24 (72%) of the cases. Twenty one (63%) had been admitted and treated with intravenous fluids in peripheral health centre for an average of 3 days before referral to this hospital. Prolonged mean duration of recognizable symptoms of 3 days accounted for a 58% bowel resection rate. Wound infection occurred in 11 (33.3%) and burst abdomen in 07 (21.2%) of cases. Faecal fistulae developed in 02 (06%) and incisional hernia developed in 03 (09%) of the patients. Overall, mortality rate was 09%.
Conclusion: the early symptoms of Intussusceptions would seem to be missed by primary health workers, with consequently high morbidity and mortality. There is an urgent need to re- emphasize these symptoms to the first line healthcare providers and parents through public enlightenment campaigns.

DOI: 10.3329/taj.v22i1.5020

TAJ 2009; 22(1): 59-63