Prolapsed intussusception in children: clinical study and therapeutic aspects (about 15 cases).

Abstract

Aim : To analyze clinical and therapeutic aspects of prolapsed intussusceptions. Patients and methods : This is a retrospective study conducted between June 1998 and May 2015 at the Department of Pediatric Surgery at the Aristide Le Dantec Hospital in Dakar, at the Surgery Department of the National Hospital Center of Nouakchott and at the Pediatric Surgery Service of the Hospital Center Mother and Child of Nouakchott. We have thus recorded fifteen observations of invasive prolapse at the anus. We studied the consultation period, the reasons for consultation, the general and physical signs, the time of intervention, the operative findings, the therapeutic methods and the follow‑up procedures. Results : All children were referred for rectal prolapse. Twelve children had abdominal pain, thirteen vomiting and seven rectal bleeding. A mass prolapsed at the anus was the constant physical sign. The rectal examination revealed a separation furrow between the mass and the rectal wall. Disinvagination by taxis was successful in seven children. Eight cases of intestinal necrosis required intestinal resection. Three children presented with a parietal suppuration and one child presented an evisceration. These complications have evolved well under treatment. Five children died. The deaths involved 3 children with extensive intestinal resection and 2 children with hemodynamic instability. Conclusion : The clinical aspects make it possible to differentiate prolapsed invagination from rectal prolapse. Surgical treatment is often delicate because of the long duration of the pathology.