Postoperative Intussusceptions in Infants and Children: A Case series

Hamza Malik, Jamaal Butt, Sajid Iqbal Nayyar, Wajeeh-Ur-Rehman, Aziz Ahmad Chattha, Nabila Talat

Abstract

Objective

To document the clinical presentation, operative findings and surgical procedures performed in patients who presented with postoperative intussusception.

Study design

Retrospective descriptive case series.

Place & Duration of study

Department of Pediatric Surgery, Children Hospital & University of Child Health Sciences Lahore, from January 2018 to December 2023.

Methods

The file records of all the patients with postoperative intussusceptions managed during the study period were reviewed. The data were collected for the number of cases encountered, demographic characteristics, clinical details such as primary diagnosis and surgeries, postoperative signs and symptoms, type of intussusception, surgical procedure performed to deal with the intussusception and follow up. Descriptive data were presented in tabular form with number and percentages.

Results

In this study ten patients with postoperative intussusception were managed at our institution. This included seven males and three females. The median age at presentation was two years. These patients were primarily operated for different surgical conditions. The most common clinical presentation included gradual abdominal distension, bilious nasogastric aspirate, and constipation after few days of primary surgery. All patients were operated again. Eight patients had ileo-ileal intussusception, one patient each had jejuno-ileal and ileo-colic intussusception. The secondary surgical procedure was tailored according to the intra-operative findings. Manual reduction of the intussusception was performed in eight patients while resection and end-to-end anastomosis were required in two children.

Conclusion

The data highlighted the importance of maintaining a high index of suspicion for postoperative intussusception in any pediatric patient who develops symptoms suggestive of intestinal obstruction after primary abdominal surgery. Early recognition and prompt intervention following diagnostic imaging remain crucial for optimal outcomes.

Key words

Intestinal obstruction, Postoperative intussusception, Bilious vomiting, Laparotomy, Ultrasonography.