A Clinical Study of Recurrent Intussusception

Yoon, K Y; Kim, B H; Park, H S; Lee, W G; Park, C M

Abstract

Intussusception is the invagination of a portion of the intestine into itself and one of the most important surgical emergency in infancy and early childhood. The etiology of mosts recurrent intussusception is unknown. Therefore, it is very difficult to identify the cause. Very few studies and references on recurrent intussusception were reported in Korea. Authors had been studied and analized 406 patients of intussusception who were treated at Hanyang University Hospital during the period of 8 years and 3 months from 1972 to 1980. 37 cases out of 406 intussusception cases had been recurred, which were analized clinically as well as epidemiologically. The results were obtained aa follows: 1. Overall recurrence rate was 9.1%. 2. The average age of patients with recurrent intussusception was 11 months distributed from the age of 4 months to 3years and 7months. There were 27boys and 10girls in the series 3. 37 patients with 63 recurrences were collected. Twenty-three children had one recurrence each, nine children had two, three children had three, one child had four, and one child had nine recurrent intussusceptions. 4. The incidence of recurrence after barium enema reduction was 15.4%, while only 5.7% after operative reduction. There were no recurrence following after surgical resection. 5. Once patients had recurrence, thereafter subsequent recurrence rate was higher as increasing frequencies. Of the 37 who suffered an initial recurrence, 14 demonstrated a second recurrence(37.8%), of these 14, five children had 3rd recurrence(35.7%), of these 5, two children had 4th recurrence(40%), and of these two, one child went on to have a ninth. 6. Recurrent intussusceptions were happened within 6 months over 80%, the earliest being within 6 hours and the latest 14 months. 7. The types of recurrent intussusceptions were 52 ileocolic(82.5%), 3 colocolic(4.8%), 2 ileoileal(3.2%) and one ileoileocolic(1.6%) with 5 unknown cases(7.9%). 8. Leading points were not founded in any cases. 9. Barium enema reduction wag attempted in all cases with success in 57 of 63(90.5%). Six patients were operated on. Four intussusceptions could be manually reduced, two were already reduced.