3세 이상 소아 장중첩증;임상양상 및 원인 분석

Abstract

Intussusception is an obstructive disease of the gastrointestinal tract which occurs more frequently in childhood than adulthood. In children over 3 year old, intussusception occurs rarely. This study analyzes the etiology and clinical features of 38 cases of intussusception treated surgically in children 3 years old or older at Yonsei Medical Center from January 1973 to December 1993. The results are as follows; 1) The age incidence between 3-4 years old was the most common(36.8%). In sex distribution, male to female ratio was 2.17: 1(26: 12). 2) The duration from the onset of symptoms to admission, for 39.5% of patients was within 24 hours,18.4% from 24 hours to 48 hours and 15.9% from 48 hours to 72 hours. 3) Frequent signs and symptoms were intermittent abdominal pain(86.8%), vomiting(63.2%), mucoid bloody stools(36.8%), and a palpable abdominal mass(21.1%). 4) The most common type was ileocolic type(42.2%), and the next was ileoileal type(28.9%). 5) Manual reduction was performed in 52.6% of the cases, intestinal resection in 36.8%. and other operative method in 10.4%. 6) The leading point was identified in 8 case9(21.1%). 7) The leading points were malignant lymphoma in 4 cases, Henoch-Scholein purpura in 2 cases, ileal polyp and Meckel's diverticulum in each 1 case. 8) Sixteen children(42.1%) were 6 years old or older and two of them had leading points(12.5%). In these two children, the leading points were malignant lymphoma. 9) In the cases of intussusception over 3 year old, leading points were more frequently found Malignant lymphoma occurred frequently as a leading point, especially in children over 6 years old. These things should be considered preoperatively.