Postoperative intussusceptions in children and infants: a systematic review

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• 作者：Gang Yang (1)
  Xuejun Wang (1)
  Wenjun Jiang (1)
  Junmei Ma (1)
  Jinliang Zhao (1)
  Wenying Liu (1)
  
• 关键词：Postoperative intussusception ; Children ; Systematic review
• 刊名：Pediatric Surgery International
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：29
• 期：12
• 页码：1273-1279
• 全文大小：
• 作者单位：Gang Yang (1)
  Xuejun Wang (1)
  Wenjun Jiang (1)
  Junmei Ma (1)
  Jinliang Zhao (1)
  Wenying Liu (1)
  
  1. Sichuan Academy of Medical Sciences and Sichuan Provincial People? Hospital, Chengdu, Sichuan, China
  
• ISSN：1437-9813

文摘

Background Postoperative intussusception (POI) is an unusual complication in children and infants who underwent various kinds of surgery. The early recognition was difficult for its rarity and atypical presentations. This study evaluates the clinical features of POI through a literature review. Methods MEDLINE database was searched for relevant articles that reported the children and infants with POI since 1990 in English-language using the key word ?ostoperative intussusception? All published studies containing clinical data for POI in children and infants were included. Reference lists of retrieved articles were reviewed for additional cases. Detailed data of the included cases were extracted and analyzed. Results Twenty-six studies with total 127 cases of POI were included. According to the extracted data, the median age was 19?months with the male-to-female ratio 1.5:1. There were 65 operations (51.2?%) that involved gastrointestinal system, 26 cases (20.5?%) of retroperitoneal tumor resection, 12 operations (9.4?%) involved diaphragm, 8 operations (6.3?%) involved urinary system, 5 cases (3.9?%) of partial pancreatectomy, 11 cases (8.7?%) of non-abdominal operations. 75.5?% presented symptoms in the first 7?days after surgery. The prominent symptom was bilious vomiting or increased nasogastric output (87.1?% of 101 patients), following abdominal distention (74.3?%), abdominal pain (35.6?%). Six cases (5.0?%) of ileocolic POI were reduced successfully by air enema. The small bowel intussusception attributed 85.6?% of POI (95 patients). Laparotomy and manual reduction were performed in 104 cases (86.0?%). Nine patients (7.4?%) underwent intestinal resection and anastomosis. Conclusions POI should be suspected in pediatric surgical patients who showed signs of intestinal obstruction in the early postoperative period. Early recognition and prompt management are important.