Retrospective surveillance of intussusception in children aged less than 2 years in a tertiary care institute of eastern India
Journal Title: Journal of Indira Gandhi Institute of Medical Sciences - Year 2018, Vol 4, Issue 1
Abstract
Abstract Objective- Intussusception is the most common cause of acute intestinal obstruction in infants and young children. Very few studies on the epidemiology of intussusception have been done in India, particularly the eastern part of our country. Government of India recently introduced rotavirus vaccine in national immunisation schedule (NIS). Earlier some licensed rotavirus vaccine had been seen to be associated with occurrence of intussusception. Though newer rotavirus vaccines have not been seen to be associated with intussusception, background data on epidemiology, clinical presentation and outcome of intussusception cases are required to correctly compare and analyse the scenario in pre and post introduction of rotavirus vaccine. Methods Retrospective surveillance of intussusception cases of age group 0-2 years admitted during period of 5 years, from March 2012 to February 2017 at IGIMS, Patna was done. For diagnosis of intussusception, Brighton collaboration working group definition was used. The baseline demographic data, clinical signs and symptoms, immunisation history (with particular emphasis on rotavirus vaccine) and diagnostic and treatment procedures were extracted for analysis. Results There were 31 confirmed cases of intussusception during study period. The median age of diagnosis was 9 months with male to female ratio of 3.2: 1. The mean time of presentation to hospital from onset of symptoms was 56.4 hours. Vomiting (80%), blood in stool (76%), abdominal pain (72.5%) and diarrhoea (52%) were the most common symptoms. Intussusception case occurred round the year with peak occurrence from January to March. No intussusception associated death was recorded. The commonest type of intussusceptions was ileo-colic (80. 4%) followed by colo-colic (12.6%). Direct surgical intervention was carried out in 66.5% cases where as in 18.2% cases surgery was required after failure of non-surgical measures. Out of 31 cases, immunisation records were found in 22 cases. None of them had been vaccinated with rotavirus Vaccine. Conclusion This study provides the baseline data of epidemiology, clinical presentation and outcome of intussusception at a tertiary care hospital. A prospective surveillance study is highly needed to assess impact of rotavirus vaccine on intussusception occurrence in the post rotavirus vaccines introduction scenario.
Authors and Affiliations
Rakesh Kumar, Vijayendra Kumar, Jayant Kumar, Zaheer Hasan, Vinit Kumar Thakur, Pankaj Kumar
Keywords
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