Primary Intussusception and Weaning Methods in Two Institutions in Nigeria with Literature Review

Abstract

Abstract Background: Primary intussusception causes intestinal obstruction in early childhood. Diet has been implicated as a causative agent and this is ascribed to the high prevalence observed during weaning; however, there is no consensus regarding the major causative factors. This study aimed to determine the type of diet during weaning as a predisposing etiological factor of intussusception. Objective: The objective of this study was to determine if there is any association during weaning with four groups of infants being those on exclusive breastfeeding, intake of infant formula, infants weaned completely, and on cereals or a mixture of all three in patients with intussusception at two Nigerian tertiary institutions. In addition, the clinical characteristics of presentation at our center were noted. Materials and Methods: This was a descriptive cross-sectional review of the records of patients aged 3–24 months who were diagnosed with intussusception using ultrasonography within a duration of two years. The information extracted included specific symptoms of the condition, type of feeding before the onset of intussusception, frequency, and association of these feeding patterns with intussusception, laboratory findings, radiological findings, and type of intussusception. Results: Exclusively breastfed infants (63%) had the highest rates of intussusception while those with the lowest incidence were completely weaned on cereals (4.5%), in between these groups were infants who were fed with formula. Among the formula group, almost half (13%) were those fed by a particular local formula. An abdominal ultrasound scan established a diagnosis in all except one patient that was confirmed at surgery. The main laboratory findings were hyponatremia and anemia. Conclusion: Diet was found to be associated with the onset of intussusception in this study, particularly in exclusively breastfed babies, and lowest in those on cereals. Early diagnosis of suspected intussusception in infants can be facilitated by making ultrasound compulsory. Hyponatremia and anemia are suggestive of late presentation of the condition.