Investigation of Recurrence Factors for Idiopathic Intussusception in Children: Focusing on Ultrasonic Findings at Terminal Ileum

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  • Horiike Masaki
    Division of Pediatric Surgery, Osaka Red Cross Hospital Division of Pediatric Surgery, Osaka City University Graduate School of Medicine
  • Ohno Koichi
    Division of Pediatric Surgery, Osaka Red Cross Hospital

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Other Title
  • 小児特発性腸重積整復後の予後予測因子の検討
  • 小児特発注腸重積整復後の予後予測因子の検討 : 超音波検査による回腸末端の所見
  • ショウニ トクハツ チュウ チョウジュウ セキ セイフク ゴ ノ ヨゴ ヨソク インシ ノ ケントウ : チョウオンパ ケンサ ニ ヨル カイチョウ マッタン ノ ショケン
  • ―超音波検査による回腸末端の所見―

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<p>Purpose: Over 75% of patients with pediatric idiopathic intussusception can be treated using high-pressure enema. However, recurrence occurs in some cases. Ileocecal lymphoid tissues play a role in the onset, but the cause of recurrence remains unclear.</p><p>Methods: We measured the wall thickness of the terminal ileum (WTTI) using ultrasound after treatment of cases of recurrent and nonrecurrent pediatric idiopathic intussusception. We included 27 patients (recurrent group, 4 patients; nonrecurrent group, 23 patients). For both groups, we considered background factors (sex, prior infection, age, body temperature, WBC count, and CRP level). We performed regression analysis to examine whether WTTI after reduction was associated with recurrence.</p><p>Results: There were no significant differences in the background factors between the groups. WTTI in the nonrecurrent group decreased rapidly. Using regression analysis, the elapsed time until 2 mm reduction was found to be 55 hours.</p><p>On the other hand, WTTI in the recurrent group decreased gradually and seemed to remain constant at 6.5 mm. There was a significant difference in the average WTTI between both groups 24 hours after reduction.</p><p>Conclusions: We found that sustained intestinal wall thickness after reduction was a factor associated with the recurrence of this disease. It is possible to predict the risk of recurrence by evaluating the trend of decrease in WTTI after reduction.</p>

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