Determining factors of clinical outcomes in paediatric intussusception at Johannesburg hospital

Description

A
research
report
submitted
to
the
Faculty
of
Health
Sciences,
University
of
the
Witwatersrand,
in
partial
fulfilment
for
the
degree
Master
of
Medicine
(Surgery) / Aim:
The
aim
of
this
research
report
is
to
assess
which
local
epidemiological
and
clinical
factors
determine
impact
on
the
morbidity
and
mortality
of
intussusception,
expressed
as
defined
clinical
outcomes.
Methods:
A
retrospective
hospital
record
review
of
paediatric
intussusception
admitted
to
Chris
Hani
Baragwanath
(CHBH)
and
Charlotte
Maxeke
Johannesburg
Academic
Hospitals
(CMJAH)
for
the
period
of
January
2007
to
April
2010
was
undertaken.
The
four
determining
factors
evaluated
are:
Duration
of
symptoms,
weight,
palpable
rectal
intussusceptum,
admission
serum
C-­‐reactive
protein,
against
seven
possible
clinical
outcomes:
Failed
pneumatic
reduction,
perforation
during
attempted
pneumatic
reduction,
intestinal
resection,
ileostomy,
relook
laparotomy,
intensive
care
unit
admission
and
mortality.
A
total
of
108
cases
were
found
of
which
11
were
excluded
from
data
analysis.
Results:
Sixty
eight
percent
of
cases
were
from
CHBH
and
a
total
of
57%
of
cases
were
referred
from
surrounding
medical
facilities.
62
of
97
cases
had
an
attempted
pneumatic
reduction
with
a
51.6%
(32/62)
success
rate
and
an
overall
success
rate
of
32/97,
33%.
Seven
cases
developed
pneumoperitoneum
during
pneumatic
reduction.
A
total
of
65
cases
underwent
surgical
management.
Of
those
81.5%
(53/65)
underwent
intestinal
resection.
Ileostomy
diversion
was
necessary
in
13.8%
(9/65)
of
operative
cases
and
11%
(7/65)
needed
a
second
surgical
procedure
during
the
initial
presenting
admission.
An
overall
mortality
rate
of
9.3%
(9/97)
is
noted.
Conclusion:
Intussusception
in
Johannesburg
is
associated
with
significant
morbidity
and
mortality.
Duration
of
symptoms
and
C
-­‐
reactive
protein
levels
are
predictive
for
clinical
outcomes
in
paediatric
intussusception.

Links & Downloads

1. http://hdl.handle.net/10539/17435

Tags

Intestinal Obstruction

Additional Fields

Identifer	oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/17435
Date	17 April 2015
Creators	Philip, Charles
Source Sets	South African National ETD Portal
Language	English
Detected Language	English
Type	Thesis
Format	application/pdf, application/pdf, application/pdf