Main Article Content
Abstract
RÉSUMÉ
Objectif. Décrire les aspects épidémiologiques, cliniques, para cliniques et thérapeutiques des invaginations intestinales du nourrisson (IIN) dans un hôpital régional gabonais. Population et méthodes. Étude prospective, descriptive, menée au Centre hospitalo-universitaire Amissa Bongo de Franceville au Gabon entre septembre 2015 à Aout 2021 où 16 nourrissons avaient été opérés d’invagination intestinale aigüe. Analyse des principales variables cliniques, paracliniques et thérapeutiques. Résultats. La moyenne d’âge était de 5,2 mois avec une prédominance masculine soit 15 garçons et 1 fille. Tous les patients avaient des douleurs abdominales, des vomissements, des rectorragies, des ballonnements abdominaux. La déshydratation était retrouvée dans 10 cas et il y avait 12 cas de pâleur conjonctivale. L’échographie retrouvait des images en cocarde siégeant en majorité dans le colon et 6 cas prolabés dans le rectum. La biologie notait 7 cas d’anémie sévère et 11 cas d’ hyperleucocytose. Toutes les IIN étaient idiopathiques .Le délai moyen de consultation était de 3,21 jours. Nous avons réalisé 3 résections intestinales avec anastomoses, 9 désinvaginations manuelles et 4 iléostomies .La durée d’hospitalisation variait de 7 à 10 jours. Un décès a été observé chez un nourrisson de 4 mois qui avait pneumopathies bilatérales, défaillance multi viscérale et COVID-19. Conclusion. L’IIN a une présentation classique au Gabon. Le pronostic est fonction du stade évolutif et du délai de prise en charge.
ABSTRACT
Objective. To describe the epidemiology, the clinical and paraclinical presentation and the management of acute intestinal intussusception of infants in a Gabonese regional hospital. Population and Methods. This was a prospective, descriptive study that was carried out between September 2015 and August 2021 at the Amissa Bongo University Hospital in Franceville, Gabon; We recruited 16 infants who had undergone surgery for acute intestinal intussusception. Our variables of study were the clinical and paraclinical data, and the management of cases. Results. The average age of children was 5.2 months with. There were 15 boys and one girl. All children had abdominal pain, vomiting, rectal bleeding and abdominal bloating. Dehydration was found in 10 cases and 12 children had conjunctival pallor. Ultrasound revealed cocoon images mostly in the colon while 6 cases had prolapsed in the rectum. Biology showed 7 cases of severe anemia and 11 cases of hyperleukocytosis. The intussusception was idiopathic for all cases. The average time delay before consultation was 3.21 days. We performed three intestinal resections with anastomoses, nine manual deinvaginations, and four ileostomies. The duration of hospitalization ranged between 7 and 10 days. One death was recorded: this was a 4-month-old infant with bilateral pneumopathy, multivisceral failure, and associated COVID-19. Conclusion. Acute intestinal intussusception has a classical presentation in Gabonese children. Prognosis depends on the clinical stage at arrival to hospital and the time delay before surgery.
Keywords
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
- Adamou H, Habou O, Ganiou K, Amadou M, James Didier L, Harouna YD et coll. Profil des invaginations intestinales aigües du nourrisson et de l’enfant à l’hopital national de Zinder. Arch pediatr 2018; 12 :12
- Ekenze SO, Mgbor SO, Okewesili OR. Routine surgical intervention for childhood intussusception in a developing country. Ann Afr Med 2010 ; 9 : 27-30
- Sami A. cause of intussusception: diffuse large B-cell non-Hodgkin’s lymphoma: a case report and review. Eur Med Pharmacol SCI 2012 ; 16 :1938-46.
- Traoré D, Sissoko F, Ongoiba N, Traoré I, Traoré AK, Koumaré AK. Intussusception : diagnostic, morbidité et mortalité dans un pays en développement. J Chir visc 2012; 149: 211-4
- Khalifa ABH, Jebali A, Kheder M, Trabelsi A. Etiologies infectieuses des invaginations intestinales aigües idiopathiques chez l’enfant. Infectious etiology of acute idiopathic intussusception in children. Ann Biol Clin 2013 ; 71 : 389-93
- Bouali O, Mouttalib S, Vial J, Galinier P. Conduite à tenir devant une invagination intestinale aigüe du nourrisson et de l’enfant. Arch Pédiatr 2015 ; 22 : 1312-7
- Boualio O, Abbo O, Izard P, Baunin P, Galiner P. Invagination intestinale aigüe du nourrisson et de l’enfant. J Pediatr urg 2012 ;
- De Lambert G, Guérin F, Franchi-Abella S, Boubnova J, Martelli H. Invagination intestinale aiguë du nourrisson et de l’enfant. J Pediatr et puéricult 2015 ; 28 :118-30
- Weihmiller SN, Monuteaux MC, Bachur RG. Ability of pediatric physicians to judge the likelihood of intussusception. Pediatr Emerg Care 2012;28: 136-40
- Baud C, Prodhomme O, Forgues D, Saguintaah M, Veyrac C, Couture A. Intussusception in infants and children. J Pediatr Radiol 2015; 55: 336-58
- Lloyd-Johnsen C, Justice F, Donath S, Bines RG. Retrospective hospital based surveillance of intussusception in cheldren in a sentinel paediatric hospital: benefits and pitfalls for use in post-marketink surveillance of rotavirus vaccines. Vaccine 2012; 30 :190-5
- Chalya PL, Kayange NM, achandika AB. Childhood intussusception at a tertiary care hospital northwestern Tanzania: a diagnostic and therapeutic challenge in resource-limited setting. Ital J Pediatr 2014 ; 40 :28
- Bentama K, Chemlal I, Benabbou M, Abssi EM, Ouananni EM, Faricha A et coll. Invagination intestinale aigüe consécutive à un lipome gaélique : à propos d’un cas. Pan Afr Med J 2012; 12: 98
- Amrani R, Messaoudi S, Seddiki A, Tazi N. Invagination intestinale aigüe révélant une maladie cœliaque chez un nourrisson de 7 mois. J Pédiatr puéricult 2015 ;28 :80-2
- Reilly NR, Aguilar KM, Green PH. Should intussusception in children prompt screening for celiac desease. J Pediatr Gastroenterol Nut 2013 ; 56 : 56-9
- Juliana V, Biardb M, Labbé A, Amata F. Une invagination intestinale aigüe atypique. Arch Pédiatr 2012 ; 19 : 526-7.
- Beres AL, Baird R. An institutional analysis and systematic review with meta - analysis of pneumatic versus hydrostatic reduction for pediatric intussusception. Surg 2013 ; 154 : 328-34.
- Eraki ME. A comparison of hydrostatic Reduction in children with intussusception versus surgery. Afr J Pediatr Surg. 2017; 14: 61-4
- Karadag CA, Abbasoglu L, Sever N, Kalyoncu MK, Yildiz A, Akin M al. Ultrasound-guided hydrostatic reduction of intussusception with saline: Safe and effective. J Pediatr Surg 2015; 50: 1563-5
- Van Trang N, Le Nguyen NT, Dao Ht, Ho VL, Tran DT, Loewen J et al. Incidence and epidemiology intussusception among infant in Ho Chi Minh City, Vietnam. J Pediatr 2014; 164:366-71.
- Bai Yz, Chen H, Wei Lin A. special type of postoperative intussusception: iléo-iléale intussusception after surgical reduction of ileocolic intussusception in infant and children. J Pediatr Surg 2009 ; 44 :755-8
- Kohl LJ, Streng A, Grote V, Koletzko S, Liese JG. Intussusception-associated hospitalisations in southern Germany. Eur J Pediatr 2010; 169 :1487-93
- Alexander R, Travrso P, Bolorunduro O, Ortega G, Chang D, Cornwelle E et al. Profiling adult intussusception patient comparing colonic virus enteric intussusception. The Am J of Surg, 2011; 222: 487-91
- Korana J, Singhavejsakul J, Laohapensang M, Wakhanrittee J, PatumanondJ. Enema reduction of intussusception: the success rate of hydrostatic and pneumatiquereduction. Ther Clin Risk Manag. 2015; 11: 1837-42.
References
Adamou H, Habou O, Ganiou K, Amadou M, James Didier L, Harouna YD et coll. Profil des invaginations intestinales aigües du nourrisson et de l’enfant à l’hopital national de Zinder. Arch pediatr 2018; 12 :12
Ekenze SO, Mgbor SO, Okewesili OR. Routine surgical intervention for childhood intussusception in a developing country. Ann Afr Med 2010 ; 9 : 27-30
Sami A. cause of intussusception: diffuse large B-cell non-Hodgkin’s lymphoma: a case report and review. Eur Med Pharmacol SCI 2012 ; 16 :1938-46.
Traoré D, Sissoko F, Ongoiba N, Traoré I, Traoré AK, Koumaré AK. Intussusception : diagnostic, morbidité et mortalité dans un pays en développement. J Chir visc 2012; 149: 211-4
Khalifa ABH, Jebali A, Kheder M, Trabelsi A. Etiologies infectieuses des invaginations intestinales aigües idiopathiques chez l’enfant. Infectious etiology of acute idiopathic intussusception in children. Ann Biol Clin 2013 ; 71 : 389-93
Bouali O, Mouttalib S, Vial J, Galinier P. Conduite à tenir devant une invagination intestinale aigüe du nourrisson et de l’enfant. Arch Pédiatr 2015 ; 22 : 1312-7
Boualio O, Abbo O, Izard P, Baunin P, Galiner P. Invagination intestinale aigüe du nourrisson et de l’enfant. J Pediatr urg 2012 ;
De Lambert G, Guérin F, Franchi-Abella S, Boubnova J, Martelli H. Invagination intestinale aiguë du nourrisson et de l’enfant. J Pediatr et puéricult 2015 ; 28 :118-30
Weihmiller SN, Monuteaux MC, Bachur RG. Ability of pediatric physicians to judge the likelihood of intussusception. Pediatr Emerg Care 2012;28: 136-40
Baud C, Prodhomme O, Forgues D, Saguintaah M, Veyrac C, Couture A. Intussusception in infants and children. J Pediatr Radiol 2015; 55: 336-58
Lloyd-Johnsen C, Justice F, Donath S, Bines RG. Retrospective hospital based surveillance of intussusception in cheldren in a sentinel paediatric hospital: benefits and pitfalls for use in post-marketink surveillance of rotavirus vaccines. Vaccine 2012; 30 :190-5
Chalya PL, Kayange NM, achandika AB. Childhood intussusception at a tertiary care hospital northwestern Tanzania: a diagnostic and therapeutic challenge in resource-limited setting. Ital J Pediatr 2014 ; 40 :28
Bentama K, Chemlal I, Benabbou M, Abssi EM, Ouananni EM, Faricha A et coll. Invagination intestinale aigüe consécutive à un lipome gaélique : à propos d’un cas. Pan Afr Med J 2012; 12: 98
Amrani R, Messaoudi S, Seddiki A, Tazi N. Invagination intestinale aigüe révélant une maladie cœliaque chez un nourrisson de 7 mois. J Pédiatr puéricult 2015 ;28 :80-2
Reilly NR, Aguilar KM, Green PH. Should intussusception in children prompt screening for celiac desease. J Pediatr Gastroenterol Nut 2013 ; 56 : 56-9
Juliana V, Biardb M, Labbé A, Amata F. Une invagination intestinale aigüe atypique. Arch Pédiatr 2012 ; 19 : 526-7.
Beres AL, Baird R. An institutional analysis and systematic review with meta - analysis of pneumatic versus hydrostatic reduction for pediatric intussusception. Surg 2013 ; 154 : 328-34.
Eraki ME. A comparison of hydrostatic Reduction in children with intussusception versus surgery. Afr J Pediatr Surg. 2017; 14: 61-4
Karadag CA, Abbasoglu L, Sever N, Kalyoncu MK, Yildiz A, Akin M al. Ultrasound-guided hydrostatic reduction of intussusception with saline: Safe and effective. J Pediatr Surg 2015; 50: 1563-5
Van Trang N, Le Nguyen NT, Dao Ht, Ho VL, Tran DT, Loewen J et al. Incidence and epidemiology intussusception among infant in Ho Chi Minh City, Vietnam. J Pediatr 2014; 164:366-71.
Bai Yz, Chen H, Wei Lin A. special type of postoperative intussusception: iléo-iléale intussusception after surgical reduction of ileocolic intussusception in infant and children. J Pediatr Surg 2009 ; 44 :755-8
Kohl LJ, Streng A, Grote V, Koletzko S, Liese JG. Intussusception-associated hospitalisations in southern Germany. Eur J Pediatr 2010; 169 :1487-93
Alexander R, Travrso P, Bolorunduro O, Ortega G, Chang D, Cornwelle E et al. Profiling adult intussusception patient comparing colonic virus enteric intussusception. The Am J of Surg, 2011; 222: 487-91
Korana J, Singhavejsakul J, Laohapensang M, Wakhanrittee J, PatumanondJ. Enema reduction of intussusception: the success rate of hydrostatic and pneumatiquereduction. Ther Clin Risk Manag. 2015; 11: 1837-42.