Predictors for bowel resection and the presence of a pathological lead point for operated childhood intussusception: a multi-centre study

Abstract

BACKGROUND/PURPOSE: IIntussusception may require bowel resection. Here, we aim to define factors that predict the need of bowel resection and the presence of pathological lead point. METHODS: A retrospective review was taken from three tertiary centres for all operated intussusception patients from January 2010 to December 2014. Patient demographics were recorded. Statistical analysis was performed and risk factors were derived by binary logistic regression. RESULTS: 5,096 patients were treated for intussusception with 73 (57 male, 16 female) operated. The median age was 23.2 months and median duration of symptoms was 2 days. 28 patients (38.4%) required bowel resection. Logistic regression demonstrated that older age (p=0.018) and longer duration of symptoms (p=0.009) were associated with bowel resection. Furthermore, older age was a predictive factor for the presence of a pathological lead point (p=0.01). A palpable abdominal mass was also found to be associated with the need of bowel resection (risk ratio 2.3) and the presence of pathological lead point (risk ratio 2.3) independently. CONCLUSIONS: Older age at presentation and a longer duration of symptoms are positive predictors for the need of bowel resection in intussusception. The presence of a pathological lead point is more likely in older children.