Abstract
In a retrospective study, 110 patients episodes with intussusception presenting to a paediatric accident and emergency (A&E) department were reviewed, with particular attention being paid to presenting symptoms, time to diagnosis, radiological investigation, management and outcome. Between 1983 and 1993 100 patients presented to this department with 110 episodes of intussusception. Delay in diagnosis of greater than 12 h from initial medical contact was associated with increased morbidity. Associated factors in delayed diagnosis were departure from the classical symptoms (pain, vomiting and blood per rectum) and the presence of diarrhoea. General practitioner (GP) referral was to the medical team (rather than the surgical team) in around 50% of cases. Irrespective of the specialty of the first hospital doctor to see the patient only 42% were diagnosed correctly within 3 h of admission. In this population diarrhoea is a common symptom of intussusception and should alert the clinician rather than reassure. Because of its many presentations and relative rarity, intussusception remains a difficult condition to diagnose.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Katz M., Phelan E., Carlin J. B., Beasley S. W. Gas enema for the reduction of intussusception: relationship between clinical signs and symptoms and outcome. AJR Am J Roentgenol. 1993 Feb;160(2):363–366. doi: 10.2214/ajr.160.2.8424351. [DOI] [PubMed] [Google Scholar]
- McDermott V. G., Taylor T., Mackenzie S., Hendry G. M. Pneumatic reduction of intussusception: clinical experience and factors affecting outcome. Clin Radiol. 1994 Jan;49(1):30–34. doi: 10.1016/s0009-9260(05)82910-1. [DOI] [PubMed] [Google Scholar]
- Momoh J. T., Lawrie J. H. Tropical paediatric intussusception--is it a different disease entity? Ann Trop Paediatr. 1981 Dec;1(4):237–240. doi: 10.1080/02724936.1981.11748095. [DOI] [PubMed] [Google Scholar]
- Reijnen J. A., Festen C., Joosten H. J., van Wieringen P. M. Atypical characteristics of a group of children with intussusception. Acta Paediatr Scand. 1990 Jun-Jul;79(6-7):675–679. doi: 10.1111/j.1651-2227.1990.tb11534.x. [DOI] [PubMed] [Google Scholar]
- Stringer M. D., Pablot S. M., Brereton R. J. Paediatric intussusception. Br J Surg. 1992 Sep;79(9):867–876. doi: 10.1002/bjs.1800790906. [DOI] [PubMed] [Google Scholar]
- Stringer M. D., Pledger G., Drake D. P. Childhood deaths from intussusception in England and Wales, 1984-9. BMJ. 1992 Mar 21;304(6829):737–739. doi: 10.1136/bmj.304.6829.737. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wilson-Storey D., MacKinlay G. A., Prescott S., Hendry G. M. Intussusception: a surgical condition. J R Coll Surg Edinb. 1988 Oct;33(5):270–273. [PubMed] [Google Scholar]