Rectal Prolapse of Intussusception - A Single Institution's Experience

 

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Abstract

Aim: The objective was to study the clinical presentation and outcome of intussusceptions prolapsing rectally. Methods: A retrospective analysis was done of 198 children who presented with intussusception at a single institution over a 5-year period. Of this group, the data of children with intussusception prolapsing rectally was studied. Results: The incidence of prolapsing intussusception in this series was 8 %. All 16 patients were infants with an average age of 5 months. The most common presenting features were rectal bleeding and abdominal mass. Only 56 % of children had abdominal pain. 4/16 children had abdominal distension and 4 had dehydration. The duration of symptoms was less than 48 hours in 14/16 patients. Air enema reduction (AER) was attempted in 14/16 patients and was successful in 8 patients. The success rate of AER was 57 %. One patient developed a perforation during AER. Manual reduction was done in six patients who failed AER and in two patients in whom AER was not attempted because of prolonged duration of symptoms (> 48 hrs). There were no recurrences in this series. Conclusion: The incidence of intussusceptions prolapsing rectally is high in this series. It can present in the absence of the cardinal symptoms of intussusception. A high index of clinical suspicion is necessary to make the diagnosis. AER is often successful and must be attempted in children who do not have contraindications for this procedure.

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Dr. Priya Ramachandran

Kanchi Kamakoti Childs Trust Hospital

12-A, Nageswara Road

Nungambakkam

Chennai - 600 034

Email: kkcthsurgeon@yahoo.co.in