Acute intussusception at the University Hospital of the West Indies: a six year review

ABSTRACT

Acute intussusception is the leading cause of intestinal obstruction in Jamaican infants. All children with this diagnosis seen at the University Hospital of the West Indies over a six year period 1986 - 1991 were reviewed. The objective being to determine the success of present management practice which employs barium enema hydrostatic reduction in clinically stable patients without peritonitis. Of the thirty-eight patients reviewed there was a male preponderance of 4.51. Ages ranged between four months and seven years with 71 percent less than one year old. 65 percent of patients presented with a history of less than 24 hours duration. The single fatality presented 30 hours after onset of symptoms. Common symptoms and signs were vomiting 89 percent, rectal bleeding 75 percent, abdominal mass 58 percent and abdominal pain 52 percent of cases. Barium enema was successful in 91 percent of cases attempted. The study vindicates a management approach which relies on clinical assessment as the only factor determining choice of treatment and suggests that barium enema reduction employed on this basis is a safe option. (AU)