2025/04/01 by Ituen, Monday, Akpanudo, Emem, Eyo, Aniekpeno +1
#Delayed #Intestinal #Intussusception #Obstruction #Paediatric Surgery #Presentation
paper · doi:10.71637/tnhj.v25i1.972
Background: Intussusception is the most common cause of intestinal obstruction in infants and children in Sub-Saharan Africa, and it is frequently associated with significant morbidity and mortality if treatment is delayed. Objective: To investigate the presentation, management, and outcomes of paediatric intussusception at the University of Uyo Teaching Hospital over a 10-year period. Materials and Methods: This retrospective, descriptive study examined children diagnosed with intussusception from January 2014 to December 2023. Data were collected from case notes and included patient’s demographics, clinical presentation, surgical procedures, intraoperative findings, and postoperative outcomes. Results: A total of 180 patients were included, comprising 103 males and 77 females (male-to-female ratio: 1.33:1). Ages ranged from 2 months to 5 years (median: 6 months, IQR 5 – 7months). Only 22 patients (12%) presented within 3 days of symptom onset. Idiopathic cases accounted for 97.2%. Ultrasonography confirmed the diagnosis in 77.8% of cases. Surgical treatment was required in 82.8% of patients, with ileocolic intussusception observed in 138 patients (76.7%). Manual reduction was performed in 38.3% of cases, while bowel resection was required in 44.4%. The overall complication rate was 40.0%, with surgical-site infections being the most common (21.1%). The mortality rate was 12.8%, with delayed presentation and reoperation identified as key predictors of mortality (p = 0.016 and 0.01, respectively). Conclusion: Late presentation remains a significant challenge in managing intussusception in our setting, contributing to high morbidity and mortality. Surgical intervention is often necessary to manage these cases effectively.