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Journal of The Korean Society of Emergency Medicine 1995;6(2): 365-370. |
| CLINICAL STUDY OF DIAGNOSTIC METHODS OF INFANTS AND CHILDREN WITH SUSPECTED INTUSSUSCEPTION IN EMERGENCY DEPARTMENT |
| Chang Hae Pyo, Hyung Seob Won, Jung Bae Park, Hyung Soo Kim, Cheol Wan Park, Keun Lee |
| Department of Emergency Medicine, Chung Ang Gil Hospital, lncheon, Korea |
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Published online: December 31, 1995. |
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| ABSTRACT |
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The purpose of this study is to evaluate the appropriate diagnostic methods for the patients with suspected intussusception. Intussusception is a state that a portion of alimentary tract is telescoped into a segment just caudad to it, and has a characteristic symptoms of cyclic irritability, vomiting, bloody stools and palpable mass. It is the most common cause of acute or acquired intestinal obstruction in infants and children, and needs early diagnosis and immediate treatment
Authors reviewed retrospectively medical records of 411 infants & children with suspected intussusception from January 1, 1992 to December 31, 1994 and report the results with literature reviews.
The results were as followings;
1) 263 cases were definite intussusception(DI) out of 411 suspected intussusception(SI).
2) The male to female ratio was 2.3 : 1 in SI and 2.8 : 1 in DI.
3) The distribution of age revealed that 85% of SI and 84% of DI were under 24 months old, and the most common age was 8 months in SI and 10 months in DI.
4) There were upper respiratory infection in 84 cases(20%), gastroenteritis in 32 cases(8%) and bronchiolitis in 8 cases(2%) as preceding diseases.
5) The simple X-ray showed gaseous bowel distension in 212 cases(52%).
6) The most common symptoms and signs were cyclic irritability and abdominal pain(94%), bloody stools(72%), palpable abdominal mass(47%), in order.
7) Of 411 patients, 252 cases(61%) were diagnosed and treated by air enema(228 cases) and/or xploration(24 cases). Among 296 cases(72%) who showed bloody stools in digital rectal examination and glycerin enema, 245 cases(83%) were confirmed as intussusception through air enema and/or operative intervention, and that corresponds to 93% of DI.
8) Intestinal perloration as complication occurred in 3 of 393 cases who underwent air and barium enema, but all of them recovered without any sequelae after operation.
Conclusively, it is thought that air enema preceded by digital rectal examination and glycerin enema is safe and useful method in diagnosis and treatment of infants and children with SI.
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| Key words:
Rectal examination, Air enema, Glycerine enema, Bloody stool |
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