Background and Objective:
Intussusception is one of the most common causes of acute intestinal obstruction and surgical emergencies in infants and children. Also
Rotavirus vaccine is being planned to be included in Iran’s national immunization program.
Intussusception due to rotavirus vaccine is a potential safety concern. The aim of this surveillance was to determine the baseline data of intussusception in under-five-year age group in Iran to facilitate the monitoring of potential side effects after the introduction of rotavirus vaccine. Materials and Methods: This hospital-based historical cohort study reviewed children under 60 months years old with the final diagnosis of intussusception, based on ICD-10 code K56.1, using census method in all hospitals of Tehran, Iran from March 2010 to March 2015. The list of the hospitals was accessible at Iran Ministry of Health and Medical Education website. Demographic (Sex, Age, Hospital ID, Admission date, Hospital stay duration), Clinical manifestations (Currant jelly stool, Abdominal pain, Vomiting, Diarrhea, Fever, Abdominal distention, Irritability, Abdominal tenderness), Diagnostic and Treatment methods (Contrast enema, Ultrasonography, Laparotomy, Laparoscopy), and outcome data of patients aged less than 5 years with diagnosis of intussusception were gathered from Medical and Surgical records by checklist, retrospectively. Data analyzed using SPSS Software version 24 (Chicago, IL, USA). Quantitative data were expressed as mean (±SD), and Qualitative data were reported as Frequency and Percentage. Also this study was conducted after receiving approval from the ethics review committee of Iran University of Medical Sciences (IUMS), Code: IR.IUMS.REC1394 .9211216322. Findings: In this study, 759 patients with diagnosis of intussusception were detected, of which 525 (69.2%) were male. 309 (40.7%) of the cases were under one year old 1 year. The mean (±SD) age of the patient’s 19.63±13.21 months. Annual incidence of intussusception was 66.54 cases per 100’000 children =<1 year and 31.61 cases per 100’000 children <5 years. Highest incidence of the disease was detected in the spring (32.3%) and autumn (26.6%) in comparison to other seasons (summer 23.6%, and winter 17.5 %). The most common symptom and sign were abdominal pain/Irritability (94.2%) and tenderness (24.2%), respectively. The diagnosis was performed by ultrasonography in 75.9% of the cases. The most frequent anatomic location was ileocolic region (57.49%). The most common treatment method was barium enema. The mean duration of hospital stay was 3.46 ±2.38 days with a median of 3 days. No deaths due to invagination or subsequent complications were identified during this 5-year study. Conclusion: This surveillance has provided a baseline data of childhood intussusception prior to the introduction of the rotavirus vaccination in
Tehran to provide a better comparison with post-introduction data.