소아의 재발성 장중첩증

Abstract

Four hundred and sixty-five patients including 33 patients of one or more recurrence, who was brought to Seoul National University Hospital during recent 9 years from Sept. 1973 to Aug 1982, were analysed. Results were as follows. 1. Overall recurrence rate was 7.196, Recurrence after barium enema reduction was 1296 and after operation was 2.3%. 2. M:F ratio was 2.06:1 with male predominance. 3. Most frequent age group was 4~6 months old. 83.3% of all cases were below 1 year old age. In recurrent cases, the most frequent age group was 7~9 months old. 4. About 60% of total cases were seen in summer and spring. 5. Preceding illness such as V.R.T or enteritis was present in 29% of cases. 6. Symptom duration of 13~24hours was most frequent. In 67% of all cases, duration was less than 24hrs. In 55% of recurrent cases, duration was less than fihrs. 7. Pain was present III 99% of cases, vomiting in 94%, abdominal pain in 56% and bloody stool in 90% of cases. 8. Anemia was present In 16.5% of cases, and leukocytosis in 5.6% of cases. 9. Location of intussusceptum were transverse coIon (26. 2%) hepatic flexure(20.590, cecum (20. 5%) and ascending colon(I6.4%) etc. in order. 10. Barium enema was tried in 402 primary cases and in 42 recurrent cases. Reduction rate was 60% of primary cases and 88.1% of recurrent cases. Operation was performed in 172 primary cases and 5 recurrent cases. Resection rate was 14.5% of all surgical cases. 11. Pathologic lesions confirmed by operation were, mesenteric adenitis (41), Peyers patch hyperplasia (9), Ileocecal band (3), Meckel's diverticulum (2), Wandering cecum (I), Lymphoma (0. 12. The most frequent time interval to the first recurrence was 1""6 months after first episode. 13. In addition to 33 patients of recurrence, febrile convulsion (ficases), postoperative ileus (5 cases), pneumonia (3 cases) and sepsis (lease) were cornplic ated. Mortality rate was 0.6%.