• Criteria for the diagnosis and treatment policy features with intussusception in children

Criteria for the diagnosis and treatment policy features with intussusception in children

PAEDIATRIC SURGERY.2016.3-4(52-53):42-50; doi 10.15574/PS.2016.52-53.42 
 

Criteria for the diagnosis and treatment policy features with intussusception in children 
 

Stakhov V. V.

Zhytomyr Region Children’s Hospital, Ukraine


Оbjective. To improve outcomes for children with intussusception by developing differential diagnostic criterion for assessing the degree of ischemic ulcers, rational treatment strategy study and improvement of surgical technology.


Materials and methods. Based on the results of treatment of 196 children with intussusception in the surgical department of the Zhytomyr Oblast Children’s Hospital over the period of 2006 and 2015. Patients were divided into two groups: the study group (SG) (89 patients) and comparison group (CG) (107 patients).


Results. Atypical clinical presentation in the form of absence of two or more symptoms of intussusception occurs in 27.27% for stage I, at 14.81% at the second stage, at 9,52% at the third stage and 8.33% for stage fourth. The greatest diagnostic sensitivity and predictive value among the conservative methods of research at intussusception has ultrasound and duplex scanning with color Doppler mapping (92.31%). For the purpose of verification stage intussusception developed a system of scoring of the degree by which systematized the main prognostic indicators ultrasound and duplex scanning with color Doppler mapping. Designed and implemented a method of treating intussusception in children with the use of laparoscopy combined with ultrasonic doppler control. Based on the studies found indications for the use of conservative and surgical treatments for intussusception in children. Among all patients in the 115 (58.67%) held conservative intussusceptum in 21 (10.71%) patients underwent laparoscopic intussusceptum, in 60 (30.61%) patients – laparotomy.


Conclusions. Determining the stage using intussusception scoring evaluation system has reduced the percentage laparotomic surgery from 48.60% to 11.59% to the CG in the GC, the number of postoperative complications from 13.08% to 4.49%, reduce postoperative mortality of 5 (4.67%) patients in CG 1 (1.12%) patients in the GC.


Key words: intussusception, children, diagnosis, treatment.


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