Clinical Manifestations of Childhood Intussusception with Ubiquitous Ultrasonography -Comparison with Small Bowel and Ileocecal Type-

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복부 초음파 검사 보편화 시대의 소아 장중첩증의 임상적 고찰

- 소장형과 대장형의 비교 -

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Table 1. Clinical Characteristics of Patients of Ileocecal and Small Bowel Intussusception (ICI and SBI)

ICI (n=86) SBI (n=58) P value

Sex (Male : Female) 52:34 32:26 0.527

Age (months) 0.004

0-12 26(30.2 %) 4(6.9 %)

12-24 30(34.9 %) 18(31.0 %)

24-36 13(15.1 %) 13(22.4 %)

36-60 11(12.8 %) 15(25.9 %)

> 60 6(7.0 %) 8(13.8 %)

Mean (months) 24.2 ± 21.6 36.6 ± 24.6 0.002

Clinical presentation

Vomiting 47(54.7 %) 34(58.6 %) 0.638

Irritability 45(52.3 %) 12(20.7 %) 0.001

Abdominal pain 45(52.3 %) 30(51.7 %) 0.944

Abdominal mass 14(16.3 %) 1( 1.7 %) 0.005

Bloody stool 13(15.1 %) 1( 1.7 %) 0.008

> 2^* 57(66.3 %) 31(53.4 %) 0.121

> 3^† 17(19.8 %) 2(3.4 %) 0.005

Symptom duration (hours) 0.043

0-12 40(46.5 %) 15(25.9 %)

12-24 20(23.3 %) 15(25.9 %)

24-48 13(15.1 %) 10(17.2 %)

> 48 13(15.1 %) 18(31.0 %)

Mean (hours) 22.1 ± 21.6 35.5 ± 27.8 0.002

Body temperature ( ) 36.7 ± 0.5 37.1 ± 0.9 0.004

WBC (/mm³) 11,022 ± 3,676 10,53 ± 5,315 0.518

CRP ( /L) 0.85 ± 1.29 1.76 ± 2.93 0.030

* Cases with symptoms more than two of irritability, vomiting, bloody stool and abdominal mass

†Cases with symptoms more than three of irritability, vomiting, bloody stool and abdominal mass

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Fig. 1. Monthly Distributions Ileocecal and Small Bowel Intussusception (ICI and SBI)

Table 2. Concomitant Diseases with Ileocecal and Small Bowel Intussusception (ICI and SBI) ICI (n=86) SBI (n=58) Total (n=144) Acute gastroenteritis 8 (9.3 %) 20 (34.5 %) 28 (19.4 %)

Pneumonia 5 (5.8 %) 7 (12.1 %) 12 (8.4 %)

Mesenteric lymphadenitis 6 (7.0 %) 6 (10.3 %) 12 (8.3 %)

Acute pharyngitis 3 (3.5 %) 5 (8.6 %) 8 (8.3 %)

Kawasaki disease 0 (0 %) 5 (8.6 %) 5 (3.2 %)

Hemolytic uremic syndrome 1 (1.2 %) 0 (0 %) 1 (0.7 %)

Henoch-Schönlein Purpura 0 (0 %) 1 (1.7 %) 1 (0.7 %)

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Table 3. Management of Ileocecal and Small Bowel Intussusception (ICI and SBI)

ICI (n=86) SBI (n=58)

Air reduction 71 (84.5 %) 0

Surgical treatment 15 (17.4 %) 0

Manual reduction 13 (15.1 %) 0

Bowel resection 2 (2.3 %) 0

Spontaneous reduction 1 (1.1 %) 58 (100 %)

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Table 4. Clinical Characteristics of Recurred Ileocecal and Small Bowel Intussusception (ICI and SBI)

Type Case Age

(months) Sex Interval (days)

Initial treatment

Treatment in recur

ICI 1* 6 M 30 Air Air

2 8 M 1 Air Air

3* 14 M 60 Air operation

4* 15 F 30 Air operation

5* 19 F 260 Air Air

6* 21 M 3 Air operation

7 25 M 1 Air Air

8* 27 F 90 operation Air

9 29 F 1 Air Air, Air^†

10 64 F 2 Air Air

SBI 11* 17 F 23 Spontaneous Spontaneous

12 18 M 1 Spontaneous Spontaneous

13 59 F 7 Spontaneous Spontaneous

* Case with re-admission due to recur, ^†Case with second recur

Air; air reduction, Spontaneous; spontaneous reduction, operation; open manual reduction

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