Intussusception in Zambia: A response to treatment recommendations in the published literature

Abstract

Intussusception is the invagination of one portion of the intestine into another and is the commonest cause of intestinal obstruction in infants and children. In North America and Europe the incidence of intussusception is estimated to be between 0.5-2.3 cases per 1000 live births, respectively. In most developing countries and many developed countries accurate estimates of the incidence of intussusception are not available. Intussusception in Zambia, and many African countries is not uncommon and characteristically seen late by surgeons. causing many management challenges. Literature studies indicate that reduction by use of hydrostatic pressure (using air or enema contrast) is the treatment of choice today and surgery is reserved for cases whose enema contrast has failed. This was not the case in this study. All patients were treated surgically since they all reported very late when complications had already taken place and contrast enema was already contraindicated. To respond to the treatment recommendations espoused in the literature and highlight the challenges faced in Zambia, and Africa in general. To disseminate the profile of intussusception seen in Zambia in order to enhance awareness, increase diagnostic alertness, and recommend management options for surgeons in developing countries. This was a 20-year.prospective study (continuous audit) of the nature of 231 intussusception cases that were managed at University Teaching Hospital in Zambian. The cases were collected prospectively and analysed systematically in retrospect. There was an average delay of 72 hours from onset of signs and symptoms presenting to the surgical unit for definitive treatment.