Frequency of Intussusception in Patients Presenting with Bloody Diarrhea

Abstract

Background: Intussusception is a common cause of intestinal obstruction in young children and may present atypically as bloody diarrhea, leading to delayed diagnosis and increased morbidity. Early identification is essential to prevent serious complications. Objective: To determine the frequency of intussusception in children presenting with bloody diarrhea at the Pediatrics Unit of Ayub Teaching Hospital, Abbottabad. Methods: This cross-sectional study was conducted from November 2024 to May 2025 and included 87 children aged 2 months to 14 years presenting with bloody diarrhea, enrolled through consecutive non-probability sampling. Children with prior abdominal surgery or congenital gastrointestinal malformations were excluded. Diagnosis of intussusception was confirmed by abdominal ultrasonography. Data were analyzed using SPSS version 27.0 and associations were assessed using Chi-square or Fisher’s exact test, with p ≤ 0.05 considered statistically significant. Results: Intussusception was diagnosed in 7 (8.04%) out of 87 children presenting with bloody diarrhea. Among these, 85.7% (n=6) were below 2 years of age, while 14.3% (n=1) were older than 2 years. A statistically significant association was observed between age <2 years and intussusception (p = 0.02). Male predominance was noted (70.1% males; male-to-female ratio 2.4:1); however, the association between gender and intussusception was not statistically significant (p = 0.93). Common presenting symptoms included abdominal pain (81.6%), vomiting (63.2%), and fever (58.6%). Conclusion: Intussusception was identified in a notable proportion of children presenting with bloody diarrhea, particularly among those under two years of age. Younger age showed a statistically significant association with intussusception, while gender did not. These findings highlight the importance of maintaining a high index of suspicion and early ultrasonographic evaluation in young children presenting with bloody diarrhea to enable timely diagnosis and reduce complications.