<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Background</h3><p>Intussusception is a common cause of obstruction in paediatric patients. Rapid clinical recognition and treatment is important to prevent potentially fatal complications. The present study aims to derive a clinical scoring system for prediction of risk of operative intervention in patients with intussusception.</p></sec>
<sec><h3>Materials and methods</h3><p>Data of 100 patients with intussusception were analyzed retrospectively, and a score was calculated based on clinical parameters – age, presence/absence of symptoms and signs such as abdominal distention, vomiting, lump abdomen, red currant jelly stools and duration of abdominal pain. The maximum score was 12, and the minimum score was 6. This score was then applied to other 50 consecutive patients with intussusception.</p></sec>
<sec><h3>Results</h3><p>Of 100, 13 patients required operative intervention; 87 patients were managed by hydrostatic reduction. In all, four patients with a score of 12 and five patients with a score of 11 required operative intervention. Seven patients had a score of 10, out of which four (57.14%) required operative intervention. A total of 87 patients who had a score of 10 or less were successfully managed non-operatively by ultrasound-guided hydrostatic reduction. In the next 50 patients, two patients with a score of 9 and all patients with scores of 10 and 11 required operative intervention. Thus, age less than 3 months and more than 2 years, presence of symptoms such as abdominal lump, red currant jelly stools and duration of abdominal pain of 2 or more days were strong predictors of operative intervention.</p></sec>
<sec><h3>Conclusion</h3><p>This clinical score helps to predict the risk of operative intervention required in a child with a diagnosis of intussusceptions – duration of abdominal pain of 48 h or more, presence of abdominal distention and lump and red currant jelly stools are strong predictors of need of operative intervention in patients with intussusception. Higher the score (8 or more, as concluded by this study), more the probability of requiring operative intervention in these patients. Though limited, this study could serve as a pilot work to develop a user-friendly score for early surgical decision making in the management of paediatric intussusception.</p></sec>
</abstract>

BackgroundIntussusception is a common cause of obstruction in paediatric patients. Rapid clinical recognition and treatment is important to prevent potentially fatal complications. The present study aims to derive a clinical scoring system for prediction of risk of operative intervention in patients with intussusception.
Materials and methodsData of 100 patients with intussusception were analyzed retrospectively, and a score was calculated based on clinical parameters – age, presence/absence of symptoms and signs such as abdominal distention, vomiting, lump abdomen, red currant jelly stools and duration of abdominal pain. The maximum score was 12, and the minimum score was 6. This score was then applied to other 50 consecutive patients with intussusception.
ResultsOf 100, 13 patients required operative intervention; 87 patients were managed by hydrostatic reduction. In all, four patients with a score of 12 and five patients with a score of 11 required operative intervention. Seven patients had a score of 10, out of which four (57.14%) required operative intervention. A total of 87 patients who had a score of 10 or less were successfully managed non-operatively by ultrasound-guided hydrostatic reduction. In the next 50 patients, two patients with a score of 9 and all patients with scores of 10 and 11 required operative intervention. Thus, age less than 3 months and more than 2 years, presence of symptoms such as abdominal lump, red currant jelly stools and duration of abdominal pain of 2 or more days were strong predictors of operative intervention.
ConclusionThis clinical score helps to predict the risk of operative intervention required in a child with a diagnosis of intussusceptions – duration of abdominal pain of 48 h or more, presence of abdominal distention and lump and red currant jelly stools are strong predictors of need of operative intervention in patients with intussusception. Higher the score (8 or more, as concluded by this study), more the probability of requiring operative intervention in these patients. Though limited, this study could serve as a pilot work to develop a user-friendly score for early surgical decision making in the management of paediatric intussusception.

Paediatric Intussusception: A Clinical Scoring System to Predict the Risk of Operative Intervention

Registrar, Department of Paediatric Surgery

Professor & Head, Department of Paediatric Surgery

Assistant Professor, Department of Paediatric Surgery

Journal of Mother and Child

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

BackgroundIntussusception is a common cause of obstruction in paediatric patients. Rapid clinical recognition and treatment is important to prevent potentially...

Total score	Total patients	Hydrostatic reduction	Surgery	Bowel resection for gangrene
10–12	4	0	4	4
9	6	4	2	2
6–8	40	40	0	–

Total score	Total patients	Hydrostatic reduction	Surgery	Bowel resection for gangrene
11–12	9	0	9	6
9–10	19	15	4	1
6–8	72	87	0	–

Score	1			2			P-value

No. of patients	Total	Hydrostatic reduction	Required surgery	Total	Hydrostatic reduction	Required surgery
Age	58	53	5	42	34	8	0.1259
Abdominal pain	73	71	2	27	16	11	<0.0001
Per abdomen (soft/distended)	77	75	2	23	12	11	<0.0001
Vomiting	20	20	0	80	67	13	0.0533
Lump	88	86	2	12	1	11	<0.0001
Red currant jelly stools	67	65	2	33	22	11	<0.0001

Score	1	2
Age	3 months to 2 years	<3 months and >2 years
Duration of abdominal pain	<48 h	>48 h
Abdomen	Soft	Distension
Vomiting	<3 episodes	>3 episodes
Abdominal lump	Absent	Present
Red currant jelly stools	Absent	Present

Paediatric Intussusception: A Clinical Scoring System to Predict the Risk of Operative Intervention

Article Category: Original Research Paper

Pubblicato online: 29 lug 2020

Pagine: 19 - 23

DOI: https://doi.org/10.34763/jmotherandchild.2020241.1934.000002

Parole chiave
Intussusception, Hydrostatic reduction, Operative intervention, Score, Clinical

© 2020 Charu Tiwari et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Figure 2

Scores of 50 prospective patients and their management

Scores of 100 patients and their management

Analysis of P-value for each variable

Scoring of patients with intussusception

Paediatric Intussusception: A Clinical Scoring System to Predict the Risk of Operative Intervention

Article Category: Original Research Paper

Pubblicato online: 29 lug 2020

Pagine: 19 - 23

DOI: https://doi.org/10.34763/jmotherandchild.2020241.1934.000002

Parole chiaveIntussusception, Hydrostatic reduction, Operative intervention, Score, Clinical

© 2020 Charu Tiwari et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Figure 2

Scores of 50 prospective patients and their management

Scores of 100 patients and their management

Analysis of P-value for each variable

Scoring of patients with intussusception

Parole chiave
Intussusception, Hydrostatic reduction, Operative intervention, Score, Clinical