INTUSSUSCEPTION PRESENTING TO A PEDIATRIC ACCIDENT AND EMERGENCY DEPARTMENT

In a retrospective study, 110 patients episodes with intussusception p resenting to a paediatric accident and emergency (A&E) department were reviewed, with particular attention being paid to presenting symptoms , time to diagnosis, radiological investigation, management and outcom e. Between 1983 and 1993 100 patients presented to this department wit h 110 episodes of intussusception. Delay in diagnosis of greater than 12 h from initial medical contact was associated with increased morbid ity. Associated factors in delayed diagnosis were departure from the c lassical symptoms (pain, vomiting and blood per rectum) and the presen ce of diarrhoea. General practitioner (GP) referral was to the medical team (rather than the surgical team) in around 50% of cases. Irrespec tive of the specialty of the first hospital doctor to see the patient only 42% were diagnosed correctly within 3 h of admission. In this pop ulation diarrhoea is a common symptom of intussusception and should al ert the clinician rather than reassure. Because of its many presentati ons and relative rarity, intussusception remains a difficult condition to diagnose.