New approaches to the diagnosis and tactics of surgical treatment of intestinal intussusception in children

Abstract

Intestinal intussusception (IR) is an urgent problem of pediatric surgery. The relevance is high due to the incidence of the disease, which ranges from 1.5 to 4 per 1000 children and tends to increase cases over the past 10 years, as well as diagnostic difficulties and a high frequency of relapses of the disease. The frequency of diagnostic mistakes reaches 75-85%, and the mortality rate for intussusception ranges from 0.5 to 1%, reaching from 6 to 14.5% in complicated forms. The aim of the study is to improve the results of treatment of intestinal intussusception in children by optimizing approaches to diagnosis and tactics of surgical treatment. Materials and methods. Over the past 20 years, 237 children aged 3 months to 12 years were hospitalized in the Department of Emergency Surgery, Specialized Pediatric Surgical Clinic of Samarkand State Medical University, with a diagnosis of intestinal intussusception, of which 116 were confirmed during a clinical examination. Depending on the applied therapeutic and tactical approaches, all examined patients with intestinal intussusception are divided into 2 groups. Group 1 (comparison group) consisted of 43 patients treated in the period from 2000 to 2013. In this group, the diagnosis was based on plain radiography and pneumoirrigoscopy. Group 2 (main group) consisted of 73 patients treated for the period from 2014 to the present. In this group, diagnosis and conservative treatment was based on the method of hydroechocolonographic disinvagination under ultrasound control.