All issues > Volume 32(1); 1989

Original Article

J Korean Pediatr Soc. 1989;32(1):34-44. Published online January 31, 1989.

Recurrent Intussusception in Infants and Children.

In Suck Ryu¹, Ki Sup Chung¹

¹Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea

Received: June 29, 1988;  Accepted: October 4, 1988.

Abstract

A clinical study of 687 patients including 76 with one or more episodes of recurrent intussusception who had been admítted to Severance Hospital, Yonsei University College of Medicine during the 5 year and 4 month period from Jan. 1982 to Apr. 1987 was made and compared with previous clinical data collected from 1977 to 1981. The results were as follows. 1) The overall recurrence rate of intussusception in this study was 11.0% which was higher than the 7.4% of our previous study. The recurrence rate after barium reduction in this study was 13.9% which was much higher than the 8.4% of our previous study, but the recurrence rate after operative reduction was 4.3%, the same in both studies 2) With regard to age distribution and recurrent intussusception, in this study, the peak incidence in infants under 1 year of age was 53.3%, which denoted a decreasing tendency in recurrence in this age group as compared with 78.9% of previous study. 3) With regard to x distribution and recurrent intussusception, male predominated in a ratio of l.6:1 in the previous study and l.4:1 in this study. 4) Primary intussusception occurred most freqently during July and August in both studies, while recurrnt intussuscepion occurred most frequently during February, April and July in this study, but during June, July and August in the previous study. 5) The average duration between the first and second attack was 8.4 months(range 4 hours to 3 years and 8 months). Of 92 patients presenting recurrent attack, intussusception recurred within 1 month in 32.6% of the cases, within 72 hours in 11%, and after 1 year in 12%. 6) The average duration of symptoms after onset but before arriving at the hospital was 7.9 hours in the recurrent group, which was significantly shorter than 19.3 hours in the primary group(p < 0.01). 7) Clinical manifestations including abdominal pain and vomiting, currant jelly stool and abdominal mass were 88.6% and 61.4~78.4% , respectively in the primary group, and 84.8% and 30.4~54.3%, respectively in the recurrent group. 8) Causative underlying diseases were found in 7.4% of the cases in the primary group and in 19. 7% in the recurrent group. The most common underlying disease of recurrent intussusception was lymphiod hyperplasia(66.7%); others included Meckel’s diverticulum, Iymphoma, band, tumor, H-S purpura, undescended cecum, non-rotation, mobile cecum and narrowed terminal ileum. 9) lleocecal intussusception was the most frequent type in 86.2% of the cases in the primary group and in 90.2% of the cases in the recurrent group. 10) Barium reduction was successful in 69.7% of the cases in the primary group and in 83.7% of the recurrent group, and operative reduction was performed in 30.3% of the primay group and in 6.3% of the recurrent group.

Keywords :Intussusception, Recurrence