ACTA FAC. MED. NAISS. 2005; 22 (2):107-111

Professional article 

CLINICAL SYMPTOMS AND SIGNS OF INVAGINATION IN CHILDREN'S POPULATION

Ivona Đorđević, Zoran Marjanović
Clinic for Pediatric Surgery,Niš

    SUMMARY
   
    Intussusception (invagination) is a specific form of bowel occlusion and stop in bowel passage. Also, it is one of the most common problems in abdominal surgical pathology in children population. It is seen in 1- 4 children per 1000 births, being more common in boys than girls (3:2), in the period from 6 to 9 months of age.
    The most frequent form is ileocecal (80%), ileocolic, ileoileal and colocolic. Most cases are idiopathic (90%), with no identifiable lesion acting as "lead point" or pathological apex of the intussusceptum. But, in 10% of all cases, specific "lead points" are found. A Meckel diverticulum is the most common lead point followed by hipertrophic lymphatic nodes, polips and duplications. Other "lead points" described include submucosal hemorrhage with Henoch-Schonlein purpura, hemangiomas and ectopic pancreatic tissue in intestinal mucos`a.
    The aim of the study was to define the commonest clinical symptoms which can help surgeon to make an adequate diagnosis of intussusception in children's population.
    During the period of three years (2002-2004), 22 patients with the diagnosis of intussusception were hospitalized at the Clinic for Pediatric Surgery in Niš. The study encompassed 14 boys (63.63%) and 8 girls (36.36%) - approximately 7.33 cases yearly. The most commonest forms of intussusception in our study were ileocecal and ileoileal (90.63%), followed with colocolic and ileicolic (9.09%). The classic triad of colicky intermittent painful crises, vomiting, and red "currant jelly" stools occurs in most of the patients. Temperature, lethargy, adynamia and convulsiones usually occur later during the process. The triad of syptoms and signs is pathognomonic for most of the patients with invagination. Early diagnosis is very important because it can provide nonsurgical treatment (by hidrostatic reduction), or less radical intervention (with no bowel resection).

    Key words: invagination, "currant jelly", clinical symptoms