Recurrent Intussusception in Infants

Background The majority of intussusceptions, between 2 months and 2 years, are idiopathic. Indication of surgery in infants with recurrences is still matter for debate. The aim of our study was to review our experience to better define the management of recurrent intussusceptions. Material and methods A retrospective study was conducted involving all patients treated for intussusception at the department of pediatric surgery of Tunis Children’s Hospital, over a 5-year period, going from 2008 through 2012. Patients admitted for more than one episode of intussusception were further investigated. Results During 5-year period, 170 infants and children younger than 2 years were diagnosed as having ileocolic intussusception. There were 10 patients with 12 recurrences. Overall recurrence rate was 6 %. Recurrent intussusception occurred in all cases following successful hydrostatic reduction. Nine infants underwent a second hydrostatic reduction of intussusception. The reduction was successful in all cases. The other infant was taken directly to the operating room because it was too sick to undergo enema. No lead point was found at surgery. The two patients who presented a second recurrence had a successful non operative reduction. Subsequent laparoscopic exploration was normal in both cases. Conclusion Based on our experience and on reviewing the literature, we recommend radiological reduction for more than the third episode of intussusceptions but we must take into consideration the socio-economic level of the parents. Surgery should be reserved for irreducible recurrences and in patients with a suspected pathologic lead point.