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    Management of Pediatric Intussusception: Review of the Treatment Algorithm (Retrospective Study)
    (Turkiye Klinikleri, 2023) Hasan, S.; Çeltik, Ü.; Divarci, E.; Ergün, O.; Özok, G.; Çelik, A.
    Objective: In large series, the clinical features, management steps, and treatment results of intussusceptions have been studied. Material and Methods: Retrospective study including intussusception patients in a single center between 2008-2021. Results: There were 406 patients: 353 (86.9%) patients with ileocolic, 30 (7.4%) patients with small bowel, and 23 (5.7%) patients colocolic intussusception. In small bowel intussusceptions, 60% (18/30) of patients were treated surgically and in 40% (12/30) spontaneous reduction happened. Pathological lead points (PLPs) were found in 23.3% (7/30) of patients. In colocolic intussusception, the nonoperative reduction was used in 22/23 patients with a 90.9% success rate. The rate of PLPs was 4.3% (1/23). In ileocolic intussusception, spontaneous reduction happened in 18% (64/353) of cases. Nonoperative reduction was used as initial treatment in 272/353 patients with 79% (215/272) success rate and surgical management was used in 22.2% (78/353) of patients. The recurrence rate was 17.2% (61/353) with 85 attacks. Nonoperative reduction was used in 65/85 of attacks with 93% success rate. PLPs rate in different age groups was: 3.8% (0-2 years), 8% (2-5 years) and 17.4% (>5 years) (p value<0.001). In the patients who are >5 years old the frequency of Burkitt lymphoma was remarkable 10.8%. Conclusion: Although the first-line approach in small bowel intussusceptions is surgical exploration, the frequency of spontaneous reduction is high in cases with short segments (<4 cm). Nonoperative reduction should be the standard initial treatment for all age groups in ileocolic and colocolic intussusceptions. Management should be done carefully in patients who are >5 years old with ileocolic intussusceptions because of the high incidence of PLPs and Burkitt’s lymphoma. © 2023 by Türkiye Klinikleri.