The morbidity and mortality of right hemicolectomy for complicated intussusception in infants

Infants with intussusception in tropical Africa frequently present late. Intestinal resection for gangrene or perforation may warrant a right hemicolectomy. Over a period of 11 year, 15 (45.5%) of 33 infants with intussusception required bowel resection, 10 of which were right hemicolectomies. The age range of those who had right hemicolectomy was 3-9 months (median 6 months) and duration of symptoms 3-8 days (median 6 days). In addition to features of intussusception, seven (78%) infants were dehydrated and one was anaemic. Six (67%) of 9 infants developed procedure related complications postoperatively. Four (44%) had anastomotic dehiscence, associated with abdominal wound dehiscence in 2. In 3 of the patients, the anastomosis leaked again following repeat resection and anastomosis, necessitating relaparotomy and stoma formation. One (11%) patient each had wound infection and prolonged ileus respectively. Six (67%) patients died, including the 4 who had anastomotic dehiscence. The cause of death was overwhelming infection in 4 patients and aspiration of vomitus in two patients. Recommendations are made to minimize morbidity and mortality in these infants.