Journal List > Korean J Pediatr Gastroenterol Nutr > v.13(2) > 1138539

Korean J Pediatr Gastroenterol Nutr. 2010 Sep;13(2):128-133. Korean.
Published online Sep 30, 2010.  https://doi.org/10.5223/kjpgn.2010.13.2.128
Copyright © 2010 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
Small Bowel Intussusception in Children: Spontaneous Resolution vs. Surgical Intervention
Mi Ran Park, M.D., Mi Sun Lim, M.D., Jeong Kee Seo, M.D., Jae Sung Ko, M.D., Ju Young Chang, M.D., Hye Ran Yang, M.D., Yoon Joung Lim, M.D.,* and Woo Sun Kim, M.D.*
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
*Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.

Corresponding author (Email: jkseo@snu.ac.kr )
Received Aug 07, 2010; Revised Aug 11, 2010; Accepted Aug 24, 2010.

Abstract

Purpose

Intussusception is one of the most common causes of an acute abdomen in infancy. The majority of pediatric cases of intussusception are of the ileocolic type and usually idiopathic. Small bowel intussusception is rarely diagnosed in children, and few cases have been reported. The purpose of this study was to determine the clinical features and causes of small bowel intussusception in children.

Methods

We retrospectively reviewed the clinical and radiologic findings of 21 children with small bowel intussusception who were admitted to Seoul National University Children's Hospital between March 2005 and January 2010.

Results

The clinical presentation of small bowel intussusception included abdominal pain or irritability (85%), vomiting (23%), fever (14%), bloody stools (14%), and abdominal masses (4%). Six patients required surgical management. Ultrasonography showed that the mean diameter of the lesions and mean thickness of the outer rims were 1.6±0.7 and 1.7±1.8 mm, respectively. Eleven lesions were located in the left abdominal or paraumbilical regions. Children who underwent surgical management were older than children with transient small bowel intussusception (mean age, 51 vs. 109 months). The mean diameter of the lesions and mean thickness of the outer rims were greater in the surgically-managed group. The location of intussusception was not significantly different between the two groups.

Conclusion

Small bowel intussusception was spontaneously reduced in a large number of pediatric patients. However, sonographic demonstration of larger size, older age, and pathologic lead point warrant surgical intervention.

Keywords: Small bowel intussusception; Children; Surgical; Spontaneous reduction

Figures


Fig. 1
Typical benign small bowel intussusceptions (jejunojejunal) in a 4 year old boy with abdominal pain. Transeverse (A) and longitudinal (B) US scan showed doughnut (A) and sandwich signs (B).
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Fig. 2
US (A) and CT scan (B) of a 5-year-old boy with recurrent abdominal pain and melena who underwent surgical reduction of small bowel intussusceptions at multiple sites (arrow). Based on biopsy, he was diagnosed with Burkitt lymphoma.
Click for larger image

Tables


Table 1
Clinical Characteristics of Small Bowel Intussusception
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Table 2
Transient Small Bowel Intussusception and Surgically Managed Small Bowel Intussusception
Click for larger image

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