2017 Volume 53 Issue 6 Pages 1149-1154
Purpose: We herein report the treatment planning of intussusception after rotavirus vaccination (RV) from its clinical features.
Methods: Eighteen infants under 6 months of age were diagnosed as having intussusception from January 2008 to December 2016. They were classified into four groups on the basis of RV presence and operation (OP) history: RV/OP (n = 2), RV/non-OP (n = 3), non-RV/OP (n = 5), and non-RV/non-OP (n = 8). We investigated retrospectively the (1) age of onset, (2) time until first enema reduction from onset, (3) maximum pressure of enema, (4) blood urea nitrogen (BUN) level, and (5) differences in operative findings between the RV/OP and non-RV/OP groups.
Results: The age tended to be lower and the time until the first enema reduction shorter in RV/OP patients than in others. The maximum pressure of enema reduction tended to be lower in non-RV/non-OP patients than in others. The BUN level tended to be higher in operated patients. Enlarged mesenteric lymph nodes (18–20 mm) were found in all RV/OP patients, but only 1 non-RV/OP patient had swollen lymph nodes over 10 mm. All RV/OP patients developed intussusception within about 2 weeks (4 days and 15 days) after the first RV. In contrast, all RV/non-OP patients developed intussusception after the second or third RV.
Conclusions: We must positively consider operative reduction for intussusception occurring within about two weeks after the first RV, as acute mesenteric lymphadenopathy may disturb the reduction physically. In patients who develop intussusception after the second or third RV, nonoperative intervention seemed relatively effective.
