PERINATAL INTUSSUSCEPTION IN PREMATURE-INFANTS

Intussusception is common in infants aged 5 to 18 months, but there ha ve been only 12 reports of its occurrence among premature infants. Nin e of these previously reported cases with adequate data and one new ca se are reviewed. Many of the infants were believed to have necrotizing enterocolitis, leading to an average 12-day interval between the onse t of signs and the operation. Bilious emesis or nasogastric contents. bloody stool, and intestinal dilation without pneumatosis intestinalis were common. A contrast enema showed the intussusception in only 1 of 7 cases. Most cases were diagnosed in the operating room and underwen t successful primary anastomosis. with no recurrences. A pathological lead point was identified in 2 of the 10 cases. The overall mortality rate was 23%; the one death since 1970 was secondary to attempted hydr ostatic reduction. These cases may represent what, in the absence of p remature delivery, would have been the intrauterine development of int ussusception likely leading to small bowel atresia. (C) 1996 by W.B. S aunders Company