Intussusception in children aged under two years in India: Retrospective surveillance at nineteen tertiary care hospitals.
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Das Manoja Kumar, Arora Narendra Kumar, Gupta Bini, Sharan Apoorva, Kameswari K, Padmalatha P, Prasad G Rajendra, Shad Jimmy, Shyamala J, Harish Kumar S, Nagender Yoga, Sharmila K, Shad Rashmi, Garge Saurabh, Bharadia Lalit, Gupta Atul, Goswami Jayanta K, Lahiri Kaushik, Sankhe Lalit, Mane Sushant, Patwari Yogini Prasad, Ajayakumar M K, Santhosh Kumar A, Sarangi Rachita, Tripathy Bikasha Bihary, Mohapatra S S G, Sahoo Subrat Kumar, Kumar Vijayendra, Kumar Rakesh, Sarkar Suman, Sarkar Ruchirendu, Sarkar Nihar Ranjan, Wakhlu Ashish, Ratan Simmi K, Dubey Anand P, Mohan Neelam, Luthra Meera, Vyas Bhadresh R, Trivedi Harsh, Mathai John, Sam Cenita J, Jothilakshmi K, Arunachalam Pavai, Bhat Javeed Iqbal, Mufti Gowhar, Charoo Bashir Ahmad, Jena Pradeep K, Debbarma Sanjib K, Ghosh Sunil K, Aggarwal Mahesh K, Haldar Pradeep, Zuber Patrick L F, Maure Christine, Bonhoeffer Jan, Ray Arindam
Аннотация
METHODS: Intussusception in children 2-23 months were documented at 19 nationally representative sentinel hospitals through a retrospective surveillance for 69 months (July 2010 to March 2016). For each case clinical, hospital course, treatment and outcome data were collected.
RESULTS: Among the 1588 intussusception cases, 54.5% were from South India and 66.3% were boys. The median age was 8 months (IQR 6, 12) with 34.6% aged 2-6 months. Seasonal variation with higher cases were documented during March-June period. The most common symptoms and signs were vomiting (63.4%), bloody stool (49.1%), abdominal pain (46.9%) and excessive crying (42.8%). The classical triad (vomiting, abdominal pain, and blood in stools) was observed in 25.6% cases. 96.4% cases were diagnosed by ultrasound with ileocolic location as the commonest (85.3%). Management was done by reduction (50.8%) and surgery (41.1%) and only 1% of the patients' died. 91.1% cases met Brighton criteria level 1 and 3.3% Level 2. Between 2010 and 2015, the case load and case ratio increased across all regions.
CONCLUSION: Intussusception cases have occurred in children across all parts of the country, with low case fatality in the settings studied. The progressive rise cases could indicate an increasing awareness and availability of diagnostic facilities.