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TÜRKÇE
Withdrawn - 30
Identifying Key Predictors for Surgical Intervention in Pediatric Ileocecal Intussusception
B Aziza, Y Houas, N Ben Alaya, NB Ghaddab, F Thamri, A Guitouni, Y Kerkeni, S Sahli, R Jouini
children hospital Bechir Hamza, Pediatric surgery department A Tunis Tunisia
Introduction :
Ileocecal intussusception (ICI) is a common cause of intestinal obstruction in children. Non-surgical reduction remains the first-line treatment . However, certain cases necessitate surgical intervention.
Aim of the study
This study aims to identify and evaluate predictive factors influencing the necessity for surgical treatment in children with ICI.
Materials and Methods
We conducted a retrospective analysis of 77 pediatric patients diagnosed with ileocecal intussusception from January 2015 to December 2023. Clinical data, including demographics, presentation characteristics, imaging findings, and treatment outcomes, were reviewed to determine factors associated with the need for surgical intervention.
Results
The cohort consisted of 77 children, with a mean age of 2.8 years . Successful non-operative reduction was achieved in 52 children (67.5%), while 25 children (32.4%) required surgical intervention. Key factors associated with the need for surgery included: younger age at presentation (p = 0.03) and a prolonged duration of symptoms before presentation (mean: 48 hours for surgical cases vs. 8 hours for conservative cases, p < 0.01). Imaging findings indicated bowel necrosis in 71% of surgical cases compared to 15% of conservative cases (p = 0.02), and the presence of a crescent-shaped sign on ultrasound was also linked to surgical intervention (p = 0.04). Additionally, associated pathologies, such as lead point lesions, were more common in surgical cases (54%) compared to conservative cases (15%, p < 0.01). Multivariate analysis confirmed that a symptom duration exceeding 48 hours was an independent predictor of the need for surgical treatment (odds ratio [OR] = 3.6, p = 0.012).
Conclusion
Predictive factors for surgical treatment of ileocecal intussusception in children include prolonged duration of symptoms, imaging evidence of bowel necrosis, and the presence of associated pathologies. Early identification of these factors is crucial for timely surgical intervention and improved patient outcomes.