• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.2
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• pp.128-133
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• 2010

Purpose: Intussusception is one of the most common causes of an acute abdomen in infancy. The majority of pediatric cases of intussusception are of the ileocolic type and usually idiopathic. Small bowel intussusception is rarely diagnosed in children, and few cases have been reported. The purpose of this study was to determine the clinical features and causes of small bowel intussusception in children. Methods: We retrospectively reviewed the clinical and radiologic findings of 21 children with small bowel intussusception who were admitted to Seoul National University Children's Hospital between March 2005 and January 2010. Results: The clinical presentation of small bowel intussusception included abdominal pain or irritability (85%), vomiting (23%), fever (14%), bloody stools (14%), and abdominal masses (4%). Six patients required surgical management. Ultrasonography showed that the mean diameter of the lesions and mean thickness of the outer rims were 1.6${\pm}$0.7 and 1.7${\pm}$1.8 mm, respectively. Eleven lesions were located in the left abdominal or paraumbilical regions. Children who underwent surgical management were older than children with transient small bowel intussusception (mean age, 51 vs. 109 months). The mean diameter of the lesions and mean thickness of the outer rims were greater in the surgically-managed group. The location of intussusception was not significantly different between the two groups. Conclusion: Small bowel intussusception was spontaneously reduced in a large number of pediatric patients. However, sonographic demonstration of larger size, older age, and pathologic lead point warrant surgical intervention.

• Advances in pediatric surgery
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• v.15 no.2
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• pp.132-140
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• 2009

The purpose of this study was to determine the success rate of air reduction as the primary treatment of intussusception and whether the success of air reduction could be predicted by plain x-ray. The authors reviewed the medical records of 54 consecutive patients diagnosed with intussusception from Jan 2005 to Dec 2007 at the Department of Surgery, Masan Samsung Hospital. The natures of symptoms and findings of plain abdominal radiography performed in the emergency department (ED) were reviewed. Air reduction failed more frequently (26.3 %) in patients who visited ED more than 24 hours after symptom onset (p=0.009). The mean duration of symptom for operated patients was longer than air reduction group (p=0.01). Also, 3/4 of patients having localized distension of small bowel in the left upper quadrant abdomen had unsuccessful air reduction (p=0.002). In conclusion, the time interval from symptom onset to arrival at ED and localized distension of small bowel in the left upper quadrant abdomen significantly increased the failure rate of air reduction.

• Childhood Kidney Diseases
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• v.20 no.2
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• pp.92-96
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• 2016

Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is the most common vasculitis in children, mainly affecting the small vessels of the skin, joints, gastrointestinal tract, and kidneys. Although most cases of HSP resolve spontaneously without sequelae, serious nephrological and intestinal problems may occur in some cases. We experienced a case of HSP complicated by simultaneous intussusception and nephritis in a 14-year-old boy who developed a sudden abdominal pain and gross hematuria on the 11th day after onset of the disease. Imaging studies revealed intussusception that required emergency laparotomy. Despite treatment with steroid and angiotensin-converting enzyme inhibitors, nephritis and nephrosis progressed for 4 weeks, and renal biopsy was performed to confirm the diagnosis. Cyclosporin A therapy was started, and remission of proteinuria was achieved after 5 months. However, the nephritis recurred and worsened to end-stage renal failure during 15 years of follow-up.

• Clinical and Experimental Pediatrics
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• v.48 no.8
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• pp.907-910
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• 2005

Intussusception and Meckel's diverticulum are very rare disorders in intrauterine or neonatal periods, which are causes of intestinal obstruction. We experienced a case of intussusception due to Meckel's diverticulum which caused intestinal obstruction in the neonate who had bilious vomiting a few hours after birth. We report this case with a brief review of the literature.

• Journal of the Korean Society of Radiology
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• v.82 no.3
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• pp.708-714
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• 2021

Intussusception and acute appendicitis are common emergency conditions in children. They should be promptly differentiated in pediatric patients presenting with suggestive symptoms. However, both diseases may occur simultaneously. Herein, we present two cases of intussusception of the appendix accompanied with appendicitis.

• Journal of the Korean Society of Radiology
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• v.83 no.6
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• pp.1380-1384
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• 2022

Endometrial carcinoma is a common gynecologic malignancy; however, metastasis to the small bowel is rare. Metastatic endometrial carcinoma usually occurs through local extension rather than distant metastasis. Isolated small bowel metastasis is extremely rare; further, intussusception with resultant intestinal obstruction is not common. We report the imaging findings of a patient with isolated small bowel metastasis of endometrial carcinoma with resultant jejunojejunal intussusception.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.247-251
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• 2005

Intussusception in a preterm neonate is a very rare disorder. We experienced a case of intrauterine intussusception presented with symptoms of the small bowel obstruction in a preterm infant whose gestational age was $28^{+2}$ weeks. Urgent ultrasonography of abdomen revealed no definite intussuscepted segment. At emergent surgery performed on the 11th days of life under the diagnosis of distal small bowel obstruction, an ileo-ileal intussusception with distal ileal atresia without perforation was found.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.4
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• pp.329-345
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• 2020

Purpose: This was a nationwide population-based study conducted to investigate the epidemiology, treatment, disease outcomes, and associated factors of childhood intussusception in South Korea. Methods: Data from the Korean National Health Insurance Service database on all patients <18 years old diagnosed with intussusception from 2007 to 2017 were analyzed. Results: A total of 34,688 cases were identified among 30,444 patients. The overall incidence was 28.3/100,000 person-years with a male predominance. Most cases (83.1%) occurred in children <3 years old, with an annual incidence of 195.2, 200.1, and 118.6 cases per 100,000 children in their first, second, and third year of life, respectively. The median age at the first occurrence was 18.7 months, and it was higher in boys than in girls. The post-discharge recurrence rate was 10.6% (3,226/30,444) and the in-hospital recurrence rate was 6.1% (1,842/30,444). The total recurrence rate (post-discharge recurrence and/or in-hospital recurrence) was 15.0% (4,580/30,444). Enema reduction was successful in 90.0% of cases. Enema reduction was more successful in girls than in boys. A total of 3,296 (10.8%) patients underwent 3,481 surgeries, including 735 (21.1%) laparoscopic surgeries. Post-discharge recurrence and surgery were significantly affected by age, sex, and hospital type. Mortality was noted in nine cases (0.03%). Conclusion: Our study provides accurate epidemiologic data on the treatment and outcomes of intussusception through complete enumeration during an 11-year-period.

• Journal of Minimally Invasive Surgery
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• v.21 no.4
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• pp.154-159
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• 2018

Purpose: Intussusception is a common cause of intestinal obstruction in children. While most patients can be treated by enema reduction, about 20% require surgery. We investigated the usefulness and feasibility of laparoscopic surgery and the intraoperative risk of bowel resection. Methods: We retrospectively reviewed pediatric patients who underwent surgery for intussusception from 2010 to 2017. We collected data for age, gender, body weight, associated symptoms, duration of symptoms, white blood cell count, operating time, and postoperative complications. Results: Of 155 patients, 37 (23.8%) underwent surgery due to enema reduction failure in 29 (78.3%), recurrence in 6 (16.3%), a suspicious lead point in 1, and suspicious ischemic change observed on ultrasonography in 1. The mean age was $26.8{\pm}18.9$ months (range, 3.5~76.7 months), and the mean body weight was $12.9{\pm}3.9kg$ (range, 5.4~22.2 kg). Laparoscopic surgery was successful in 29 patients (78.4%), and 7 (18.9%) needed bowel resection and anastomosis. The mean operating time was $56.7{\pm}32.8min$. A lead point was found in 3 patients in the bowel resection group (p=0.005); in addition, the operating time and hospital stay were longer in this group. There were no intra- or postoperative complications. Conclusion: Laparoscopic surgery was successful in 78.4% of the patients with a short hospital stay and early oral intake. The only predictive factor for bowel resection was the presence of a lead point. Laparoscopic surgery may be an optimal treatment intervention for children with intussusception, except for those who show initial peritonitis.

• Advances in pediatric surgery
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• v.9 no.1
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• pp.24-29
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• 2003

To evaluate the clinical findings of the recurrent intussusception, 351 patients with 445 intussusceptions were reviewed. Recurrence rate, pattern of recurrence, reducibility, pathologic lead points (PLP), and operative findings and long term follow up of the multiple recurrences were analyzed. Of 351 patients, 303 had no recurrence, 26 had one recurrence, and 22 had multiple recurrences. Over all recurrence rate was 16.4% ; 18.5% were managed by air reduction, 16.2% by barium reduction and 5.9% by operation. Eleven PLPs were proved operatively and an additional 6 suspected PLPs were depicted radiologically. The most frequent PLP was ileal lymphoid hyperplasia. Intervals between reduction and recurrence were less than 2 weeks in 31 cases, between 2 weeks and 1 year in 55, and more than 1 year in 8. The longest interval was 2 years and 4 months.