Considering that the evaluations performed, including CT, endoscopy, scintigraphy, or exploratory surgery, were not conducted routinely in the recurrence cases in this study, conclusions about the association between pathologic anatomical leading points and the recurrence of intussusception are also limited. Children with these risk factors require close observation and a good educational program should be provided to parents to increase their awareness of a possible recurrence.
Conflict of Interest: The authors have no financial conflicts of interest. Original Article Open Access. Pediatr Gastroenterol Hepatol Nutr. Published online Mar 07, Correspondence to Hyo-Jeong Jang. Email: bearinspring hotmail. This article has been cited by 6 articles in This article has been cited by G o o g l e Scholar. This article has been cited by 1 article in PubMed Central.
This article has been cited by 4 articles in Scopus. This article has been cited by 5 articles in Web of Science. Go to:. Purpose The aim of the study was to identify factors related to the recurrence of intussusception in pediatric patients. Methods The medical charts of patients diagnosed with intussusception and treated at Dongsan Medical Center, between March to June , were retrospectively reviewed. Results Among patients, 23 patients Intussusception ; Pediatrics ; Recurrence ; Risk factor.
Intussusception: evolution of current management. J Pediatr Gastroenterol Nutr ;— Chronic ileocolic intussusception due to transmural infiltration of diffuse large B cell lymphoma in a year-old boy: a case report. Springerplus ; Ileal duplication causing recurrent intussusception. J Surg Educ ;— Inflammatory fibroid polyp: a rare benign tumor of the alimentary tract in children presenting as intussusception-case report and review of literature.
European J Pediatr Surg Rep ;— Inverted Meckel diverticulum as a lead point of small bowel intussusception: misinterpreting case as a lipoma. Clin Imaging ;— Patterns of recurrence of intussusception in children: a year review.
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Pediatr Gastroenterol Hepatol Nutr ;— Pediatric intussusception in Northern Iran: comparison of recurrent with non-recurrent cases. Iran J Pediatr ;e Recurrent intussusception in children and infants. Afr J Paediatr Surg ;— Risk factors for recurrent intussusception in children: a retrospective cohort study. BMJ Open ;7:e A clinical evaluation of the pediatric recurrent intussusception. Ann Surg Treat Res ;— The risk factors related to recurrent intussusception by ultrasonography.
Korean J Pediatr ;— Orloff MJ. Intussusception in children and adults. Surg Gynecol Obstet ;— Carty HM. Paediatric emergencies: non-traumatic abdominal emergencies. Eur Radiol ;— Three-year surveillance of intussusception in children in Switzerland. Pediatrics ;— Management of recurrent intussusception: nonoperative or operative reduction? W-G and Z-H contributed equally. Competing interests: None declared.
Provenance and peer review: Not commissioned; externally peer reviewed. Data sharing statement: No additional data are available. National Center for Biotechnology Information , U. BMJ Open. Published online Nov Author information Article notes Copyright and License information Disclaimer. Correspondence to Dr Jian Wang; moc.
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Associated Data Supplementary Materials Reviewer comments. Abstract Objective The aim of this study was to assess the frequency of clinical features and pathological lead points in recurrent intussusception, with a special focus on the risk factors that lead to recurrent intussusception. Design This is a retrospective cohort study. Setting This is a retrospective chart review of recurrent intussusception cases in a large university teaching hospital. Participants The medical records were obtained for cases with intussusception, including demographics, clinical signs and symptoms, imaging and recurrence times if available.
Interventions Univariate and multivariate logistic regression analyses were used to measure significant factors affecting recurrent intussusception and recurrent intussusception with pathological lead points. Results There were total episodes of recurrence in patients. Keywords: intussusception, recurrence, affecting factors. Strengths and limitations of this study. Introduction Intussusception is one of the most frequent causes of intestinal obstruction in infants and children, and most intussusception cases are idiopathic.
Study groups Recurrent intussusception was defined as the recurrence of intussusception after air enema reduction or surgery.
Patterns of recurrence Single-recurrent intussusception was defined as the cases that recurred only once after air enema reduction or surgery. Recurrent intussusception with lead points present Recurrent intussusception with lead points present was defined as the cases after air enema reduction with confirmed lead points by surgery.
Mass location The mass location in the right abdomen was defined as the cases in which the mass was on the right side of the spine. Statistical analysis Data are presented as numbers n and percentages. Results Clinical characteristics of recurrent intussusception cases There were total episodes of recurrence in patients.
Open in a separate window. Figure 1. Figure 2. Table 1 Age and sex distribution of recurrence cases from January to July Predictors of recurrent intussusception Table 2 shows the clinical characteristics of the recurrent intussusception cases. Table 2 Comparison of recurrent with non-recurrent intussusceptions. Table 3 The stepwise regression model of risk factors of recurrent intussusception. Predictors of recurrent intussusception with lead points Table 4 shows the clinical characteristics of recurrent intussusception cases with lead points.
Table 4 Comparison of recurrent intussusception with or without pathological lead points present in recurrent cases. Table 5 The stepwise regression model of risk factors of recurrent intussusception with pathological lead points present. Table 6 Comparison of different recurrence numbers of intussusception. Discussion General findings in recurrent intussusception Recurrent intussusception is relatively common.
Factors for detecting recurrent intussusception To investigate the factors that might influence recurrent intussusception, the clinical characteristics, mass location and pathological findings of children with intussusception were described. J Pediatr Surg ; Recurrent intussusception.
Arch Pediatr Adolesc Med ; Ein SH. Recurrent intussusception in children. Recurrent intussusception: Safe use of hydrostatic enema.
Recurrent intussusception: Barium or surgery? The reason for the choice of OR was the retrospective design of the meta-analysis based on published studies that varied in design, subjects' population, primary outcome measure, and research quality Forest plot was depicted to present the pooled OR value and heterogeneity was evaluated using I 2 statistic.
Due to the potential statistical heterogeneity, a random effect model was chosen to synthesize data instead of a fixed-effect model when assessing the role of sex, blood in stool, vomiting, PLP, and right abdominal mass in developing RI. Data analysis was performed with Revman 5. The flow-chart of this meta-analysis is shown in Figure 1. Initially, studies from three databases PubMed, Cochrane, and Embase were retrieved and a total of 1, articles were screened based on the title and abstracts after eliminating the duplicates.
Further, 24 studies were assessed for eligibility by reviewing full-text articles. Among these articles, seven studies did not compare the outcome of RI patients with a control group whose enema reduction was successful and did not show recurrence unsuitable setting of group ; two did not focus on the pediatric population alone; and five did not provide useful information. Finally, 10 studies were included in this meta-analysis.
The characteristics of the nine enrolled studies are presented in Table 1. First, except for two American studies, all the others were on the Asian population, which slightly lessened the ethnic confounding factor naturally. Second, the methods for reduction used in these studies were all non-operative; one study used Altrasound-guided saline enema, three studies used barium enema, five studies chose pneumatic enema reduction, and Chen et al.
Based on that, four studies did not find any significant determinants to predict the presence of RI. Five studies provided the information about how age influences the onset of RI and two reported that the absence of vomiting happens more frequently in RI. Both Guo et al. Besides, Vo et al. All the included studies had a seven-plus score, which guaranteed the eligibility for meta-analysis.
Publication bias was assessed via funnel graphs. Based on the symmetry of the funnel graphs, it was less likely that this meta-analysis had publication bias in the models for abdominal pain, blood in stool, and sex, although it showed a high susceptibility for publication bias in the other models.
Only Vo et al. Information about the presence of fever in the participants was extracted from three studies. Both Champoux et al. Although Xie et al. Kim et al. Data pertaining to blood in stool were collected from six studies. Guo et al. The other four studies did not find any relationship. Detailed data about the abdominal pain were extracted from four studies, and all of them did not present a positive finding.
Data related to the presence of vomiting in the participants were extracted from five studies. Data regarding the presence of PLP in participants were extracted from four studies. Among these, Guo et al. Because of the heterogeneity of the data, age in each of the studies could not be statistically pooled; thus, qualitative evaluation based on six related studies was taken.
Similarly, Kim et al. Vo et al. This meta-analysis included ten studies in which 1, children who recovered from intussusception with a recurrence and 10, without recurrence were enrolled. The following potential risk factors of RI were investigated: sex, fever, blood in stool, abdominal pain, vomiting, pathological lead point PLP , and location of the mass.
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