Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Clinical features of transient small bowel intussusception in children

소아에서의 일과성 소장형 장중첩증의 임상적 고찰

  • Heo, Ji Seung (Departments of Pediatrics, College of Medicine, Hallym University) ;
  • Seo, Eun Min (Departments of Pediatrics, College of Medicine, Hallym University) ;
  • Shim, Eun Jung (Departments of Pediatrics, College of Medicine, Hallym University) ;
  • Cho, Do Jun (Departments of Pediatrics, College of Medicine, Hallym University) ;
  • Kim, Dug Ha (Departments of Pediatrics, College of Medicine, Hallym University) ;
  • Min, Ki Sik (Departments of Pediatrics, College of Medicine, Hallym University) ;
  • Yoo, Ki Yang (Departments of Pediatrics, College of Medicine, Hallym University) ;
  • Lee, Kwan Seop (Departments of Radiology, College of Medicine, Hallym University)
  • 허지승 (한림대학교 의과대학 소아과학교실) ;
  • 서은민 (한림대학교 의과대학 소아과학교실) ;
  • 심은정 (한림대학교 의과대학 소아과학교실) ;
  • 조도준 (한림대학교 의과대학 소아과학교실) ;
  • 김덕하 (한림대학교 의과대학 소아과학교실) ;
  • 민기식 (한림대학교 의과대학 소아과학교실) ;
  • 유기양 (한림대학교 의과대학 소아과학교실) ;
  • 이관섭 (한림대학교 의과대학 영상의학과학교실)
  • Received : 2008.01.15
  • Accepted : 2008.03.05
  • Published : 2008.05.15
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Abstract

Purpose : We analyzed the clinical features, management and outcome of small bowel intussusception in children compared with ileocolic intussusception. Methods : We retrospectively reviewed the records of 210 children with documented intussusception, in whom intussusception was initially diagnosed by ultrasonography during the four-year period of 2002 to 2005. Results : A total of 191 children were diagnosed with ileocolic intussusception and 19 were diagnosed with small bowel intussusception. Children with small bowel intussusception were older than children with ileocolic intussusception (P<0.05). In comparison to patients with ileocolic intussusception the characteristic presenting symptoms- such as currant jelly stool and palpable mass- were rarely observed in patients with small bowel intussusception. In ileocolic intussusception, air reduction (92.2%), or surgical reduction (7.3%) was performed; however, in small bowel intussusception, spontaneous reduction (78.9%) was observed and no surgical reduction was required in our study. Conclusion : Conservative management with close observation and follow-up sonographic evaluation rather than an immediate operation is recommended for children with small bowel intussusception.

목 적 : 본 연구는 대장형 장중첩증과 비교하여 소아에서 일시적 소장형 장중첩증의 임상양상에 관하여 알아보고자 하였다. 방 법 : 2002년 1월부터 2005년 12월까지 한림대학교 성심병원 소아과에서 장중첩증으로 진단받은 210명의 환아를 대상으로 하여 소장형 장중첩증과 대장형 장중첩증으로 분류하여 후향적 연구를 통해서 이루어졌으며, 전체 210례 중 191례는 대장형이었고 19례에서 소장형이었다. 결 과 : 소장형 장중첩증은 평균 나이가 29.5개월로 대장형 장중첩증(21.2개월)보다 많았으며, 혈변이나 복부 종괴 등의 전형적인 증상은 드문 편이었다. 치료에 있어서 대장형 장중첩증은 공기 주입식 정복술이 92.2%, 수술적인 정복이 7.3%였던 반면, 소장형 장중첩증은 78.9%가 자연 정복되었으며 수술적인 처치를 한 예는 없었다. 결 론 : 성인과는 달리 소아에서의 소장형 장중첩증은 자연 정복이 많고 수술적 치료가 드물며 소아에서의 대장형 장중첩증에 비해 발생 연령이 많았다. 또한 전형적인 임상 양상을 보이는 경우가 적으므로 진단과 치료에 있어서 주의를 필요로 한다.

Keywords

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