WOFAPS 2025 8th World Congress of Pediatric Surgery

Nedra Zouabi ¹, Sabrine Ben Youssef ¹, Syrine Laribi ¹, Samia Belhssan ¹, Sawsen Chakroun ²

¹ Pediatric surgery department, Fattouma Bourguiba Hospital, Monastir, Tunisia
² Pediatric anaesthesia and intensive care department, Fattouma Bourguiba Hospital, Monastir, Tunisia

Purpose: Acute Intestinal Intussusception (AII) is the most common abdominal emergency leading to intestinal obstruction in children aged 2 to 24 months. Although it is rare in children over 5 years of age according to most studies and caused mainly by pathological lead points (PLP). Recently, an increase in the frequency of AII occurring after the age of 5 years was noted and it was idiopathic in the majority of cases. This study aimed to report the demographic and clinico-radio-therapeutic features of AII in children over 5 years.

Methods: A retrospective study including children aged over 5 and under 15 years who were hospitalized for AII over an 11-year period.

Results: This retrospective study reviewed 112 cases of acute intestinal intussusception (AII) in children aged between 5 and 13 years. A male predominance was observed (sex ratio 2.86). Abdominal ultrasound confirmed ileocecal intussusception in all cases, with coelio-mesenteric lymphadenopathy in 81.3% and suspected PLP in 3.57%. Three patients had significant peritoneal effusion, and in 4 cases, bowel viability was uncertain. Hydrostatic reduction was attempted in 109 patients, successful in 85.32% (93 cases), without perforation. Surgery was required in 21 cases: 3 due to poor general condition, 16 for failed reduction, and 2 for suspicious ultrasound findings. Manual reduction succeeded in 19 cases (13 preserved bowel vitality). Resection was needed in 8 patients (4 Meckel’s diverticulum, 4 ischemia). Histopathology confirmed PLP in 8 of the 21 operated cases (38.1%): 4 Meckel’s diverticulum, 3 Burkitt’s lymphoma, and 1 Henoch–Schönlein purpura-related hematoma.

Conclusion: AII in children over 5 years is no longer rare, representing 9.6% of 1169 AII cases in this study. Contrary to prior reports associating AII with PLP in older children, 92.86% of cases were idiopathic.