Intussusception in a tropical country: Comparison among patient populations in Jakarta, Jogyakarta, and Amsterdam

Background: Intussusception is the most common cause of intestinal obstruct ion in young children, and high mortality rates remain a problem in develop ing countries. The purpose of this study was to describe and elucidate the differences in outcome between groups of children with intussusception in I ndonesia, a developing country, and The Netherlands, a developed country. Methods: In this retrospective review, 176 patients were studied in three t ypes of hospitals. A comparison was made among children treated at a primar y care rural hospital in Indonesia, at a secondary care urban hospital in I ndonesia, and at a tertiary care urban hospital in The Netherlands. Results: Children in the rural community hospital in Indonesia were more se verely ill at arrival and had a significantly longer duration of symptoms, an increased incidence of nonviable bowel, and a mortality rate of 20%, in contrast to a mortality rate of 3% in the urban hospital in Indonesia and n o deaths in the Dutch hospital. Conclusions: The mortality of children with intussusception in rural Indone sia is much higher than in urban Indonesia or in The Netherlands, probably because of delayed treatment, which results in more patients undergoing sur gery in worse physical condition.