MỐI LIÊN QUAN GIỮA MỘT SỐ ĐẶC ĐIỂM LÂM SÀNG VÀ SIÊU ÂM VỚI QUYẾT ĐỊNH PHƯƠNG PHÁP ĐIỀU TRỊ LỒNG RUỘT Ở TRẺ EM TẠI BỆNH VIỆN NHI ĐỒNG CẦN THƠ

Abstract

Background: Intussusception is a common cause of intestinal obstruction in children. Pneumatic reduction is the first-line treatment, with a high success rate; however, some cases still fail and require surgical intervention. Objectives:  To describe the clinical and ultrasonographic features of intussusception and to investigate predictive factors for treatment outcomes. Materials and methods: A prospective cross-sectional study was conducted on 94 pediatric patients diagnosed and treated for intussusception at Can Tho Children's Hospital from May 2023 to January 2024. Results: A total of 94 pediatric patients were included in the study, with 54 males (57.4%) and a male-to-female ratio of 1.35/1. The mean age was 29.53±22 months. Among the patients, 69.2% were admitted within 24 hours of symptom onset. The most common clinical symptoms included intermittent abdominal pain or crying episodes (82.9%), bloody stools (39.4%), vomit (47.9%) and palpable abdominal mass (40.4%). On ultrasound, the mean transverse diameter of the intussusception mass was 30.1±3.9mm, the mean length was 49.2±6.4mm. The success rate of pneumatic reduction was 93.6%, while surgical reduction was required in 6.4% of cases. Factors influencing the decision between pneumatic reduction and surgery included age, time to hospital admission, presence of bloody stools, transverse diameter and length of the intussusception mass, trapped fluid within the mass, and signs of intestinal obstruction on ultrasound. Conclusions: When diagnosing intussusception in children, predictive factors for reduction failure and surgical outcomes should be carefully considered to avoid serious complications.