Introduction: Intussusception is the most common cause of intestinal obstruction in infancy and early childhood. Over 90% of the disease occurs in children of to 3 years of age. Currently there are non-surgical methods as well as surgical.

Materials and methods: In the years: 2002-2012 in USD Department of Surgery and Traumatology in Lublin N=205 patients in total were treated for intestinal intussusception. In the examined group 57,56% (N = 118/205) were treated by surgery ,while the remaining 42,44% (N = 87/205) non-surgical. After admission to the hospital, preliminary diagnostic imaging was performed in USD Department of Radiology (abdominal X-ray, abdominal ultrasound) and laboratory tests (blood group, blood cell count, urinalysis, CRP). On the basis of the whole clinical picture, patients were qualified for conservative treatment or surgery. Non-surgical procedure is to create barium/gastrografin enema under X-ray control. The procedure was performed at the Department of Radiology involving the radiologist. In cases of failure of the non-surgical procedures, patients were eligible for surgery. Operating procedure (primary surgery or after unsuccessful barium enema) consisted of the performance of laparotomy, manual reduction of intussusception and using additional surgical procedures according to the intraoperative image (Meckl’s diverticulum resection, intestinal anastomosis, the create of a stoma).

Results: 9,25% (N = 19/205) of the patients were qualified for surgical treatment initially without the attempt of conservative treatment by barium/gastrografin enema, the remaining 48,29% (N = 99/205) qualified secondarily to surgical treatment after ineffective conservative treatment attempts. 42,44% (N = 87/205) of patients were under conservative treatment from the 8.29% (N = 17/205) in the preliminary clinical observation and 34.15% (N = 70/205) using enema. In 32,2% (N = 66/205) of patients positive therapeutic effects after a single enema was achieved, and in 1,95% (N = 4/205) after repeated enema. For patients with intussusception in the following years there was a statistically significant decrease in performed operations (in 2012 4% of patients treated surgically vs. 14% of treated conservatively). There has been no recorded perforation of the intestine at the time of the enema. There were also no deaths among the whole group of treated children. 

Introduction: The basic method of the diagnosis for Hirschprung’s disease (HD) is a rectal suction biopsy. The definitive diagnosis is confirmed by the absence of ganglion cells in the bowel submucosa. Diagnostic difficulties arise when the specimen is taken too shallow. The additional test is the evaluation of acetylocholinesterase activity (AChE), however, this test excludes the sample from further evaluation for ganglion cells. Calretinin (CL) immunohistochemistry may also be helpful as a marker of the presence of ganglion cells. This test does not destroy the sample, which can be evaluated for ganglion cells.

Aim: To assess the diagnostic value of calretinin immunochemistry in the rectum wall in rectal suction biopsy in suspected Hirschsprung disease. Material and Method: We analyzed 121 rectal suction biopsies in children with HD suspicion, from 2014 to June 2016. AChE activity was determined in all cases. Forty expressions of CL were performed.

Results: 28 biopsies (23%) were inconclusive for histological evaluation of ganglion cells. AChE activity in 22 cases was inconclusive (18%). CL expression could not be determined in 1 case (2.5%), in the remaining 39 cases the result was unequivocal (positive in 24, negative in 15 cases). CL evaluation had 100% accuracy in the diagnosis / exclusion of aganglionosis, based on the final histological examination.

Conclusions: Evaluation of calretinin (CL) immunohistochemistry in rectal suction biopsy is possible in 97.5% of cases and in the initial experiment it achieves 100% diagnostic accuracy. The value of this test exceeds the stain for AchE activity, due to the greater diagnostic accuracy and allowing further ganglion cells evaluation in the same specimen.