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A Clinical Study on Intussusception in Infancy and Childhood.

Journal of the Korean Pediatric Society 1987;30(2):150-157.
Published online February 28, 1987.
A Clinical Study on Intussusception in Infancy and Childhood.
Seung Myun Won, Bok Lyun Kim, Jae Ock Park, Sang Jhoo Lee
Department of Pediatrics, College of Medicine, Soon Chun Hyang University, Seoul, Korea
소아 장중첩중에 관한 임상적 고찰
원성면, 김복련, 박재옥, 이상주
순천향대학 의학부 소아과학교실
Intussusception which is the most common cause of acquired intestinal obstruction during infancy and early childhood requires emergent diagnosis and treatment because if untreated the infant is nearly always fatal. A clinical evaluation was performed on 190 cases of intussusception in infants and children, who were admitted to the Pediatric department of Soon Chun Hyang University Hospital from Jan. 1979 to Dec. 1983. The results were as follows: 1) In the age distribution, 82.2% of the patients were under 1 year of age and the peak incidence was 6 to 12 months of age (49.5%). 2) The male to female ratio was 1.6:1 thereby, male was more predominant than female. 3) In the annual incidence, there was no significant difference. 4) In the seasonal incidence, the most prevalent season was summer (form June to August) but no significant difference was noted among other seasons. 5) The most commonly associated disease was upper respiratory illness (30%) but no associated disease was noted in 65.8% of the cases on admission. 6) In the etiology, 82.2% (51 cases among 62 cases of operation) was idiopathic. 7 cases of hyperplasia of mesenteric lymph node and 4 cases of appendicitis were detected as organic causes. 7) The cardinal clinical manifestations were paroxysmal crying (96.8%), mucus and blood in stool (89.5%), vomiting (82.1%), and abdominal mass (71.6%) in decreasing order. In 67.4% of the cases, the 3 cardinal manifestations of paroxysmal crying, mucus & blood in stool and vomiting were present all together. 8) About leukocyte count on admission, 71.1% of the cases showed leukocytosis (WBC count >10,000/mm3). 9) The X-ray findings of simple abdomen showed the absence of colon gas(55.1%), gaseous distension of bowel(43.5%), air-fluid levels(36.2%) and a mass shadow(19.6%). 10) In the treatment, 67.4% of the cases were reduced successfully by barium enema. The longer duration of symptoms prior to admission, the lower success rate of barium enema. Among 62 cases of operation, manual reduction was done in 61 cases and segmental resection & anastomosis was done in 1 case. 11) The most common type of intussusception was ileocolic (39.3%) and the next one was colocolic (32.6%). 12) Recurrent rate was 8.9% (17 cases among 190 cases). Previously, 16 cases among 17 cases were treated by barium enema and 1 case was treated by manual reduction.
Key Words: Intussusception.

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