Document Detail

Transanal protrusion of intussusception in infants is associated with high morbidity and mortality.
MedLine Citation:
PMID:  19021945     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although anal protrusion of intussusception in infants is well recognised, it is rarely reported and confusion with rectal prolapse often results in delayed diagnosis and treatment. This report highlights the problems of diagnosis and the morbidity and mortality associated with this condition. METHOD: A retrospective case series of five infants presenting to Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Nigeria with anal protrusion of intussusception over a period of 5 years. During that time, 17 children were treated for intussusception at ABUTH. RESULTS: The anal protrusion rate of intussusception was 29%. The five infants were three girls and two boys aged 4-18 months (median 8). The duration of symptoms was between 6 and 28 days (median 21). The features were mainly protruding anal mass, diarrhoea and vomiting. Abdominal pain and passage of bloody stools occurred late. There was delay in referral and treatment owing to misdiagnosis as rectal prolapse. The intussusception was ileocolic in four patients and in one the type could not be ascertained before death. Two patients had perforation of the involved intestine and another had gangrene of the intestine, necessitating intestinal resection. In one patient, there was no bowel compromise and only open reduction was necessary. Two patients died from overwhelming infection, one before surgery and another after surgery. CONCLUSION: The risk of morbidity and mortality in anal protruding intussusception is high. As early features might not be typical of intussusception, a high index of suspicion is necessary to avoid confusion with rectal prolapse so as not to delay diagnosis and treatment.
E A Ameh; P M Mshelbwala
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Annals of tropical paediatrics     Volume:  28     ISSN:  1465-3281     ISO Abbreviation:  Ann Trop Paediatr     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-21     Completed Date:  2009-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8210625     Medline TA:  Ann Trop Paediatr     Country:  England    
Other Details:
Languages:  eng     Pagination:  287-92     Citation Subset:  IM    
Division of Paediatric Surgery, Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
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MeSH Terms
Anal Canal*
Diagnosis, Differential
Gangrene / etiology
Intestines / pathology
Intussusception / complications,  diagnosis*,  therapy
Rectal Prolapse / diagnosis
Retrospective Studies
Treatment Outcome

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