Table 2.
The clinicopathological characteristics and management of the children with intussusception in India
| Variable Category | North (n = 136) |
South (n = 262) |
East (n = 190) |
West (n = 33) |
Total (n = 621) |
P value | |
|---|---|---|---|---|---|---|---|
| Symptoms, n (%) | Vomitinga | 100 (73.5) | 187 (71.4) | 137 (72.1) | 27 (81.8) | 451 (72.6) | 0.64 |
| Bilious vomitingb | 21 (15.4) | 26 (9.9) | 34 (17.9) | 9 (27.3) | 90 (14.5) | 0.02 | |
| Abdominal pain | 102 (75.0) | 118 (45.0) | 138 (72.6) | 10 (30.3) | 368 (59.3) | < 0.01 | |
| Excessive crying | 49 (36.0) | 172 (65.7) | 109 (57.4) | 17 (51.5) | 347 (55.9) | < 0.01 | |
| Abdominal distension | 34 (25.0) | 29 (11.1) | 69 (36.3) | 3 (9.1) | 135 (21.7) | < 0.01 | |
| Rectal bleeding | 81 (59.6) | 123 (47.0) | 139 (73.2) | 18 (54.6) | 361 (58.1) | < 0.01 | |
| Diarrhoea | 23 (16.9) | 69 (26.3) | 37 (19.5) | 9 (27.3) | 138 (22.2) | 0.11 | |
| Constipation | 18 (13.2) | 43 (16.4) | 12 (6.3) | 3 (9.1) | 76 (12.2) | 0.01 | |
| Fever | 34 (25.0) | 64 (24.4) | 31 (16.3) | 13 (39.4) | 142 (22.9) | 0.02 | |
| Lethargy | 2 (1.5) | 16 (6.1) | 16 (8.4) | 2 (6.1) | 36 (5.8) | 0.07 | |
| Altered sensorium | 1 (0.7) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (0.2) | – | |
| Classical triadc | 52 (38.2) | 64 (24.4) | 87 (45.8) | 13 (39.4) | 216 (34.8) | < 0.01 | |
| Signs, n (%) | Pallor | 11 (8.1) | 14 (5.3) | 18 (9.5) | 3 (9.1) | 46 (7.4) | 0.39 |
| Dehydration | 7 (5.2) | 21 (8.0) | 43 (22.6) | 2 (6.1) | 73 (11.8) | < 0.01 | |
| Fever | 4 (2.9) | 23 (8.8) | 23 (12.1) | 5 (15.2) | 55 (8.9) | 0.02 | |
| Lethargy | 11 (8.1) | 14 (5.3) | 20 (10.5) | 3 (9.1) | 48 (7.7) | 0.23 | |
| Abdominal distension | 22 (16.2) | 25 (9.5) | 62 (32.6) | 3 (9.1) | 112 (18.0) | < 0.01 | |
| Abdominal tenderness | 13 (9.6) | 26 (9.9) | 26 (13.7) | 5 (15.2) | 70 (11.3) | 0.48 | |
| Abdominal mass | 13 (9.6) | 91 (34.7) | 24 (12.6) | 4 (12.1) | 132 (21.3) | < 0.01 | |
| Bowel sound (absent/ abnormal) | 11 (8.1) | 10 (3.8) | 43 (22.6) | 2 (6.1) | 66 (10.6) | < 0.01 | |
| Rectal prolapse | 15 (11.0) | 2 (0.8) | 1 (0.5) | 0 (0.0) | 18 (2.9) | < 0.01 | |
| Rectal mass | 3 (2.2) | 4 (1.5) | 11 (5.8) | 0 (0.0) | 18 (2.9) | 0.04 | |
| Blood on PR examination | 19 (14.0) | 31 (11.8) | 94 (49.5) | 19 (57.6) | 163 (26.3) | < 0.01 | |
| Modified triadd | 83 (61.0) | 125 (47.7) | 143 (75.3) | 21 (63.6) | 372 (59.9) | < 0.01 | |
| Diagnosis method, n (%) | Ultrasound | 121 (89.0) | 262 (100) | 179 (94.2) | 30 (90.9) | 592 (95.3) | < 0.01 |
| CT scan | 2 (1.5) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 2 (0.3) | – | |
| Barium enema | 1 (0.7) | 0 (0.0) | 1 (0.5) | 1 (3.0) | 3 (0.5) | – | |
| Surgery | 12 (8.8) | 0 (0.0) | 10 (5.3) | 2 (6.1) | 24 (3.9) | < 0.01 | |
| Intussusception location, n (%) | Colo-colic | 3 (2.2) | 10 (3.8) | 5 (2.6) | 3 (9.1) | 21 (3.4) | < 0.01 |
| Ileo-colo-colic | 8 (5.9) | 7 (2.7) | 4 (2.1) | 2 (6.1) | 21 (3.4) | < 0.01 | |
| Ileo-ileal | 11 (8.1) | 3 (1.2) | 10 (5.3) | 6 (18.2) | 30 (4.8) | < 0.01 | |
| Ileo-ileo-colic | 4 (2.9) | 5 (1.9) | 6 (3.2) | 0 (0.0) | 15 (2.4) | < 0.01 | |
| Ileocolic | 109 (80.2) | 234 (89.3) | 163 (85.8) | 20 (60.1) | 526 (84.7) | < 0.01 | |
| Jejuno-jejunum | 0 (0.0) | 0 (0.0) | 1 (0.9) | 1 (3.0) | 2 (0.3) | – | |
| > 1 locatione | 1 (0.7) | 3 (1.2) | 1(0.5) | 1 (3.0) | 6 (1.0) | – | |
| Pathological lead point, n (%) | Lymph node | 41 (30.1) | 19 (7.2) | 3 (1.6) | 15 (45.4) | 78 (12.6) | < 0.01 |
| Appendix | 0 (0.0) | 0 (0.0) | 2 (1.0) | 1 (3.0) | 3 (0.4) | – | |
| Payer’s patch | 1 (0.7) | 1 (0.3) | 1 (0.5) | 0 (0.0) | 3 (0.4) | – | |
| Polyp | 1 (0.7) | 0 (0.0) | 0 (0.0) | 1 (3.0) | 2 (0.3) | – | |
| Othersf | 2 (1.4) | 0 (0.0) | 3 (1.6) | 0 (0.0) | 5 (0.8) | – | |
| Any lead point | 45 (33.0) | 20 (7.6) | 9 (4.7) | 17 (51.5) | 91 (14.6) | < 0.01 | |
| Treatment modality, n (%) | Reduction | 56 (41.2) | 216 (82.4) | 20 (10.5) | 14 (42.4) | 306 (49.3) | < 0.01 |
| Surgery | 68 (50.0) | 30 (11.5) | 135 (71.1) | 12 (36.4) | 245 (39.5) | < 0.01 | |
| Spontaneously resolvedg | 12 (8.8) | 16 (6.1) | 34 (17.9) | 7 (21.2) | 69 (11.1) | < 0.01 | |
| Noneh | 0 (0.0) | 0 (0.0) | 1 (0.5) | 0 (0.0) | 1 (0.2) | – | |
| Surgery type, n (%) | No resectioni | 41 (60.3) | 25 (83.3) | 106 (78.6) | 9 (75) | 181 (73.9) | < 0.01 |
| With resectioni | 27 (39.7) | 5 (16.7) | 29 (21.5) | 3 (25.0) | 64 (26.1) | < 0.01 | |
| Outcome, n (%) | Discharged | 129 (94.9) | 262 (100) | 181 (95.3) | 31 (93.9) | 603 (97.1) | < 0.01 |
| Referred | 0 (0.0) | 0 (0.0) | 1 (0.5) | 2 (6.1) | 3 (0.5) | – | |
| LAMAj | 3 (2.2) | 0 (0.0) | 1 (0.5) | 0 (0.0) | 4 (0.6) | – | |
| Died | 4 (2.9) | 0 (0.0) | 7 (3.7) | 0 (0.0) | 11 (1.8) | – | |
| Brighton Collaboration Criteria level, n (%) | Level 1 | 125 (91.9) | 246 (93.9) | 156 (82.1) | 26 (78.8) | 553 (89.1) | < 0.01 |
| Level 2 | 5 (3.7) | 15 (5.7) | 24 (12.6) | 3 (9.1) | 47 (7.6) | < 0.01 | |
| Level 3 | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | – | |
| No level | 6 (4.4) | 1 (0.4) | 10 (5.3) | 4 (12.1) | 21 (3.4) | < 0.01 | |
| Illness in last 4 weeks, n (%) | Diarrhoea | 10 (7.4) | 55 (21.0) | 11 (5.8) | 4 (12.1) | 80 (12.9) | 0.04 |
| ARI | 17 (12.5) | 104 (39.7) | 21 (11.1) | 5 (15.2) | 147 (23.7) | 0.04 |
Notes: PR Per-rectal, ARI Acute respiratory illnesses
aIncludes all vomiting including bilious vomiting
bIncludes only bilious vomiting
cClassical triad includes abdominal pain, vomiting and blood in stool
dModified triad includes abdominal pain, vomiting and rectal bleeding (detected either as blood in stool or blood on per-rectal examination)
eThe location of intussusception at more than one site; such as Ileo-colic + Colo-colic, Ileo-colic + Ileo-colo-colic, Ileo-colic + Ileo-ileo-colic, Ileo-colic + Ileo-ileal
fOthers include cyst, Meckel’s diverticulum, incisional hernia, intraluminal growth and malrotation
gSpontaneously resolved: The patient was managed with IV fluids and nil orally, not required any additional intervention
h None- No definite treatment could be provided, as the patient(s) was referred or died before any definite treatment
i The denominators used for percentage estimation include patients undergone surgery only
jLAMA: Left against medical advice
The p values for some parameters could not be estimated due to no value in at least two groups