Preliminary data presented to the American Paediatric Surgical Association 30th Annual Meeting, Rancho Mirage, California, USA, May 1999
Article first published online: 4 DEC 2002
© 2001 British Journal of Surgery Society Ltd
British Journal of Surgery
Volume 88, Issue 6, pages 878–883, 1 June 2001
How to Cite
Willetts, I. E., Kite, P., Barclay, G. R., Banks, R. E., Rumley, A., Allgar, V. and Stringer, M. D. (2001), Endotoxin, cytokines and lipid peroxides in children with intussusception. Br J Surg, 88: 878–883. doi: 10.1046/j.0007-1323.2001.01799.x
The Editors have satisfied themselves that all authors have contributed significantly to this publication
- Issue published online: 4 DEC 2002
- Article first published online: 4 DEC 2002
- Manuscript Accepted: 16 FEB 2001
Intussusception is a relatively common paediatric surgical emergency. The aim of this study was to investigate selected inflammatory mediators in children with acute intussusception and to identify potentially useful plasma markers of clinical outcome.
Clinical, radiographic, operative and pathological details were recorded prospectively of all children presenting to a single institution with a confirmed diagnosis of acute intussusception during 1 year. Paired acute and convalescent venous blood samples were collected in a standard manner for blinded analysis of the following: malondialdehyde, C-reactive protein (CRP), interleukin (IL) 6, neopterin, tumour necrosis factor α, endotoxin, and immunoglobulin (Ig) G and IgM antiendotoxin core antibody (EndoCAb).
Thirty-two consecutive children (23 boys, nine girls) with a median age of 4 months were studied. Acute ileocolic intussusception was managed by air enema reduction (n = 19), operative reduction (n = 8) or surgical resection (n = 5). Peripheral blood cultures were sterile. Acute levels of plasma IL-6, neopterin and CRP were significantly raised in comparison to both normal laboratory ranges and convalescent samples (P < 0·001). Using stepwise discriminant analysis, CRP was identified as the best variable at distinguishing between the three treatment groups (P < 0·001). IgM EndoCAb concentrations were significantly greater in the convalescent sera of all the patients (P < 0·001).
Acute ileocolic intussusception in childhood is associated with endotoxinaemia and significantly raised levels of circulating inflammatory cytokines. Plasma CRP at diagnosis showed a statistically significant positive correlation with disease severity. © 2001 British Journal of Surgery Society Ltd