INTOSSUSCEPTION IN CHILDREN: CLINICAL AND LABORATORY CRITERIA FOUND IN INTESTINAL NECROSIS

Purpose of the study: determine clinical and laboratory signs in patients with invagination enabling to suspect development of irreversible circulation disturbances in the intussusceptum. Materials and methods. The results of treatment of 216 patients aged 2 months to 15 years old with the intestinal intussusceptum and complications from 2000 to 2015 were analyzed in 146 boys (67%) and 70 girls (33%). Intussusception was the most frequently met at the age of 5 to 11 months old (123 children - 57%). The main symptoms of intussusception were attack-like anxiety in 197 patents (91%), vomiting in 164 (75%), blood admixture in feces in 53 (24%) and volumetric formation in the abdomen in 103 (47%) found on palpation. Symptoms of intoxication and dehydration were found in all the patients with intussusception complications. Results. Conservative treatment (pneumodisinvagination) was performed in 168 children. 48 patients were operated. Irreversible circulation disturbances were found in 6 (12.5%) patients only. Clinical and laboratory criteria such as fatigue, vomiting with bile, blood in feces, fever, pronounced leukocytosis, electrolytic disturbances, change in the acid-base balance (metabolic acidosis), increased level of lactate indicating at the high risk of intestinal necrosis are found in patients with irreversible circulatory disturbances in the intussusceptum. Conclusions. There are signs of irreversible circulatory disturbances in the intussusceptum. It’s the combination of clinical and laboratory criteria but not every separate sign that proves there is a high risk of irreversible circulatory disturbances in the intussusceptum and which is the ground for a surgery.

инвагинация, факторы риска, некроз кишки, intussusception, risk factors, intestinal necrosis