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Paediatric Intussusception: A Clinical Scoring System to Predict the Risk of Operative Intervention

BACKGROUND: Intussusception is a common cause of obstruction in paediatric patients. Rapid clinical recognition and treatment is important to prevent potentially fatal complications. The present study aims to derive a clinical scoring system for prediction of risk of operative intervention in patien...

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Autores principales: Tiwari, Charu, Shah, Hemanshi, Sandlas, Gursev, Bothra, Jyoti
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sciendo 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518106/
https://www.ncbi.nlm.nih.gov/pubmed/33074184
http://dx.doi.org/10.34763/jmotherandchild.2020241.1934.000002
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author Tiwari, Charu
Shah, Hemanshi
Sandlas, Gursev
Bothra, Jyoti
author_facet Tiwari, Charu
Shah, Hemanshi
Sandlas, Gursev
Bothra, Jyoti
author_sort Tiwari, Charu
collection PubMed
description BACKGROUND: Intussusception is a common cause of obstruction in paediatric patients. Rapid clinical recognition and treatment is important to prevent potentially fatal complications. The present study aims to derive a clinical scoring system for prediction of risk of operative intervention in patients with intussusception. MATERIALS AND METHODS: Data of 100 patients with intussusception were analyzed retrospectively, and a score was calculated based on clinical parameters – age, presence/absence of symptoms and signs such as abdominal distention, vomiting, lump abdomen, red currant jelly stools and duration of abdominal pain. The maximum score was 12, and the minimum score was 6. This score was then applied to other 50 consecutive patients with intussusception. RESULTS: Of 100, 13 patients required operative intervention; 87 patients were managed by hydrostatic reduction. In all, four patients with a score of 12 and five patients with a score of 11 required operative intervention. Seven patients had a score of 10, out of which four (57.14%) required operative intervention. A total of 87 patients who had a score of 10 or less were successfully managed non-operatively by ultrasound-guided hydrostatic reduction. In the next 50 patients, two patients with a score of 9 and all patients with scores of 10 and 11 required operative intervention. Thus, age less than 3 months and more than 2 years, presence of symptoms such as abdominal lump, red currant jelly stools and duration of abdominal pain of 2 or more days were strong predictors of operative intervention. CONCLUSION: This clinical score helps to predict the risk of operative intervention required in a child with a diagnosis of intussusceptions – duration of abdominal pain of 48 h or more, presence of abdominal distention and lump and red currant jelly stools are strong predictors of need of operative intervention in patients with intussusception. Higher the score (8 or more, as concluded by this study), more the probability of requiring operative intervention in these patients. Though limited, this study could serve as a pilot work to develop a user-friendly score for early surgical decision making in the management of paediatric intussusception.
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spelling pubmed-85181062021-11-23 Paediatric Intussusception: A Clinical Scoring System to Predict the Risk of Operative Intervention Tiwari, Charu Shah, Hemanshi Sandlas, Gursev Bothra, Jyoti J Mother Child Original Research Paper BACKGROUND: Intussusception is a common cause of obstruction in paediatric patients. Rapid clinical recognition and treatment is important to prevent potentially fatal complications. The present study aims to derive a clinical scoring system for prediction of risk of operative intervention in patients with intussusception. MATERIALS AND METHODS: Data of 100 patients with intussusception were analyzed retrospectively, and a score was calculated based on clinical parameters – age, presence/absence of symptoms and signs such as abdominal distention, vomiting, lump abdomen, red currant jelly stools and duration of abdominal pain. The maximum score was 12, and the minimum score was 6. This score was then applied to other 50 consecutive patients with intussusception. RESULTS: Of 100, 13 patients required operative intervention; 87 patients were managed by hydrostatic reduction. In all, four patients with a score of 12 and five patients with a score of 11 required operative intervention. Seven patients had a score of 10, out of which four (57.14%) required operative intervention. A total of 87 patients who had a score of 10 or less were successfully managed non-operatively by ultrasound-guided hydrostatic reduction. In the next 50 patients, two patients with a score of 9 and all patients with scores of 10 and 11 required operative intervention. Thus, age less than 3 months and more than 2 years, presence of symptoms such as abdominal lump, red currant jelly stools and duration of abdominal pain of 2 or more days were strong predictors of operative intervention. CONCLUSION: This clinical score helps to predict the risk of operative intervention required in a child with a diagnosis of intussusceptions – duration of abdominal pain of 48 h or more, presence of abdominal distention and lump and red currant jelly stools are strong predictors of need of operative intervention in patients with intussusception. Higher the score (8 or more, as concluded by this study), more the probability of requiring operative intervention in these patients. Though limited, this study could serve as a pilot work to develop a user-friendly score for early surgical decision making in the management of paediatric intussusception. Sciendo 2020-07-29 /pmc/articles/PMC8518106/ /pubmed/33074184 http://dx.doi.org/10.34763/jmotherandchild.2020241.1934.000002 Text en © 2020 Charu Tiwari et al., published by Sciendo https://creativecommons.org/licenses/by/4.0/This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
spellingShingle Original Research Paper
Tiwari, Charu
Shah, Hemanshi
Sandlas, Gursev
Bothra, Jyoti
Paediatric Intussusception: A Clinical Scoring System to Predict the Risk of Operative Intervention
title Paediatric Intussusception: A Clinical Scoring System to Predict the Risk of Operative Intervention
title_full Paediatric Intussusception: A Clinical Scoring System to Predict the Risk of Operative Intervention
title_fullStr Paediatric Intussusception: A Clinical Scoring System to Predict the Risk of Operative Intervention
title_full_unstemmed Paediatric Intussusception: A Clinical Scoring System to Predict the Risk of Operative Intervention
title_short Paediatric Intussusception: A Clinical Scoring System to Predict the Risk of Operative Intervention
title_sort paediatric intussusception: a clinical scoring system to predict the risk of operative intervention
topic Original Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8518106/
https://www.ncbi.nlm.nih.gov/pubmed/33074184
http://dx.doi.org/10.34763/jmotherandchild.2020241.1934.000002
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