Risk Factors for Recurrent Intussusception in Children: A Record Based Descriptive Study

Abstract

Introduction: Early diagnosis and management of cases of recurrent intussusception is challenging. It is well accepted that Pathological Lead Points (PLP) can precipitate recurrence. A few recent studies have identified association of a few clinical variables with recurrence. Aim: To assess the frequency of clinical features and PLP in recurrent intussusception and to find the risk factors that lead to recurrence. Materials and Methods: This was a retrospective cohort study that included medical records and ultrasound scan registry of children with intussusceptions treated with ultrasound guided hydrostatic saline reduction or surgery, between January 2010 to December 2017 in a Government Tertiary care and teaching institution. Totally, 362 cases of intussusceptions were reviewed. Follow-up data were collected. There were 86 recurrent cases: 64 had single and 22 had multiple recurrences. The clinical parameters-age of child, gender, duration of symptoms, presence of vomiting, bloody stools, abdominal mass, ultrasound features, PLP identified, were evaluated. Fisher’s-exact test and logistic regression analysis were used to measure significant factors affecting recurrent intussusception. Results: After comparing recurrent and non-recurrent cases, it was determined that factors-age >1 year, shorter duration of symptoms (≤24 hrs), absence of vomiting and absence of bloody stools were significantly and independently associated with recurrent intussusception. Conclusion: Intussusception in older children with shorter duration of symptoms and subtle clinical features need to be followed-up closely for recurrence.

Keywords

• bloody stools
• hydrostatic saline reduction
• pathological lead points