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Management of ileocolic intussusception in the Czech Republic

Publication at First Faculty of Medicine, Faculty of Physical Education and Sport, Faculty of Medicine in Pilsen, Second Faculty of Medicine, Third Faculty of Medicine |
2021

Abstract

Introduction: Ileocolic intussusception is one of the most frequent causes of acute abdomen in infants and toddlers. The purpose of this study was to evaluate the treatment of ileocolic intussusception in the Czech Republic in 2019.

Methods: Fourteen departments of paediatric surgery participated in this multicentre retrospective study. A SurveyMonkey Inc. questionnaire was used for anonymous data collection of patients with ileocolic intussusception.

Results: In 2019, ileocolic intussusception was diagnosed in 162 patients; median age was 30 months (3 months to 9.5 years). Contrast enema was indicated in 133 patients, primary surgery in 14 patients and spontaneous reduction was found in 15 patients.

All departments using contrast enema had a success rate of 89.5%; 12 departments approached the contrast enema procedure under general anaesthesia (including myorelaxation at 7 departments) and 2 departments under sedation. Contrast enema under general anaesthesia with/without myorelaxation was significantly more successful than contrast enema under sedation (108/113, 95.6% vs 11/20, 55%; p<0.0001).

In total, 28 patients were treated surgically, in 14 primary surgery was performed. Both surgical treatment and bowel resection were statistically significantly more frequent in departments where contrast enema was performed under sedation in comparison to departments performing contrast enema under general anaesthesia (9/20, 45% vs 19/142, 13.4%; p=0.0018 and 7/9, 77.8% vs 5/19, 26.3% p=0.0166).

Conclusion: The success rate of contrast enema in the Czech Republic was 89.5%. The highest success rate is achieved by performing contrast enema under general anaesthesia.