摘要
Background/Purpose:We aim to justify the need for surgical intervention in our patients with childhood small bowel intussusceptions (SBIs) and review the current concepts in childhood SBI. Materials and Methods:We retrospectively reviewed the clinical charts of all patients with surgically confirmed SBI between July 1999 and October 2002. Demographic data,clinical presentation and inves-tigations,operative and pathologic findings,and outcome were analyzed. Results:Of 173 patients with intussusception,6 (3.5% ) were diagnosed with SBI. Median age was 11 months. Ultrasonography revealed intussusceptions in all patients,but only 1 was diagnosed with SBI. Air enema reductions were attempted in 4 of 6 patients with all ending up in failure and surgery. Surgery revealed ileoileal intussusceptions in 4 patients and jejunojejunal intussusceptions in 2 patients. Two patients had long intussusceptions meas-uring between 30 and 50 cm in length. Five patients had pathologic lead points,and bowel complications occurred in 2 patients. All underwent bowel resection and primary anastomosis. Conclusion:Despite reports on spontaneous reduction of SBI,surgery was unavoidable in all our patients with SBI because of the presence of pathologic lead points and/or bowel complications. Air enema reduction was ineffective in SBI. Due caution should be exercised when selecting patients for expectant management.
Background/Purpose:We aim to justify the need for surgical intervention in our patients with childhood small bowel intussusceptions (SBIs) and review the current concepts in childhood SBI. Materials and Methods:We retrospectively reviewed the clinical charts of all patients with surgically confirmed SBI between July 1999 and October 2002. Demographic data,clinical presentation and inves-tigations,operative and pathologic findings,and outcome were analyzed. Results:Of 173 patients with intussusception,6 (3.5% ) were diagnosed with SBI. Median age was 11 months. Ultrasonography revealed intussusceptions in all patients,but only 1 was diagnosed with SBI. Air enema reductions were attempted in 4 of 6 patients with all ending up in failure and surgery. Surgery revealed ileoileal intussusceptions in 4 patients and jejunojejunal intussusceptions in 2 patients. Two patients had long intussusceptions meas-uring between 30 and 50 cm in length. Five patients had pathologic lead points,and bowel complications occurred in 2 patients. All underwent bowel resection and primary anastomosis. Conclusion:Despite reports on spontaneous reduction of SBI,surgery was unavoidable in all our patients with SBI because of the presence of pathologic lead points and/or bowel complications. Air enema reduction was ineffective in SBI. Due caution should be exercised when selecting patients for expectant management.
