Risk factors for recurrence of intussusception in pediatric patients: A retrospective study

J Pediatr Surg. 2018 Nov;53(11):2307-2311. doi: 10.1016/j.jpedsurg.2018.03.023. Epub 2018 Mar 28.

Abstract

Objectives: The aim of this study was to explore the risk factors associated with recurrence of intussusception after operative or nonoperative reduction in children.

Methods: Between January 2004 and December 2012, patients with intussusception treated with nonoperative and operative reduction were retrospectively analyzed. We included the patients who were diagnosed with intussusception from the age of 0 year to 18 years who received nonoperative and operative reduction as an initial treatment. The data collected included demographic data (sex, age, and bodyweight), symptoms (vomiting, abdominal pain, rectal bleeding, diarrhea, distention, constipation, and duration of symptoms), signs (temperature, palpable mass, and location of the mass), investigations (ultrasound findings) and the method of reduction.

Results: The risk factors for recurrence of idiopathic intussusception were analyzed by the univariable analysis and multivariable analysis. In the univariable model, the significant risk factors for recurrence of intussusception analyzed were age, bodyweight, duration of symptoms, rectal bleeding, poor prognosis signs on ultrasound scans, location of mass, and pathological lead point. After multivariable analysis was done, we found that the significant risk factors for recurrence of intussusception were age ≥ 2 years (OR = 5.597, P = 0.044), duration of symptoms ≥48 h (OR = 91.664, P < 0.001), rectal bleeding (OR = 4.758, P = 0.009), location of mass (left over right side) (OR = 0.038, P < 0.001), pathological lead point (OR = 0.002, P < 0.001).

Conclusion: Our study found that age ≥ 2 years, duration of symptoms≥48 h, rectal bleeding, location of mass (left over right side) and pathological lead point were risk factors for recurrence of intussusception.

Level of evidence: Prognosis study.

Type of study: Retrospective study.

Keywords: Intussusception; Pediatric; Recurrence; Risk factors.

MeSH terms

  • Abdominal Pain / etiology
  • Child, Preschool
  • Colonic Diseases / complications
  • Colonic Diseases / diagnostic imaging
  • Colonic Diseases / surgery
  • Colonic Diseases / therapy*
  • Constipation / etiology
  • Female
  • Gastrointestinal Hemorrhage / etiology
  • Humans
  • Ileal Diseases / complications
  • Ileal Diseases / diagnostic imaging
  • Ileal Diseases / surgery
  • Ileal Diseases / therapy*
  • Infant
  • Intussusception / complications
  • Intussusception / diagnostic imaging
  • Intussusception / surgery
  • Intussusception / therapy*
  • Male
  • Prognosis
  • Rectum
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Ultrasonography
  • Vomiting / etiology