Pediatr Gastroenterol Hepatol Nutr.  2019 Mar;22(2):142-151. 10.5223/pghn.2019.22.2.142.

Identifying Predictive Factors for the Recurrence of Pediatric Intussusception

Affiliations
  • 1Department of Pediatrics, Keimyung University School of Medicine, Dongsan Medical Center, Daegu, Korea. bearinspring@hotmail.com
  • 2Department of Radiology, Keimyung University School of Medicine, Daegu, Korea.

Abstract

PURPOSE
The aim of the study was to identify factors related to the recurrence of intussusception in pediatric patients.
METHODS
The medical charts of patients diagnosed with intussusception and treated at Dongsan Medical Center, between March 2015 to June 2017, were retrospectively reviewed. Univariate and multivariate analyses were performed.
RESULTS
Among 137 patients, 23 patients (16.8%) had a recurrent intussusception and 8 of these patients (6%) had more than 2 episodes of recurrence. The age at diagnosis was significantly different between the non-recurrence and recurrence group (p=0.026), with age >1 year at the time of diagnosis associated with a greater rate of recurrence (p=0.002). The time interval from symptom onset to the initial reduction ( < 48 vs. ≥48 hours) was significantly longer in the recurrence group (p=0.034) and patients in the recurrence group had higher levels of C-reactive protein (CRP) (p=0.024). Bloody stools and a history of infection were significantly more frequent in the non-recurrence group (p=0.001 and p < 0.001, respectively). On stepwise regression analysis, age >1 year at the time of presentation (odds ratio [OR], 4.79; 95% confidence interval [CI], 1.56-14.06; p=0.016) and no history of infection (OR, 0.18; 95% CI, 0.06-0.58; p=0.004) were retained as predictors of recurrence.
CONCLUSION
Patients with intussusception who are older than 1 year at diagnosis, have an elevated CRP level, a delay of ≥48 hours between symptom onset and the initial reduction, an absence of bloody stools, and no history of infection should be closely monitoring for symptoms and signs of a possible recurrence.

Keyword

Intussusception; Pediatrics; Recurrence; Risk factor
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