Clinical characteristics and predictors for the presence of pediatric intussusception secondary to pathological lead points.
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PURPOSE: To analyze the clinical characteristics and identify independent predictors of intussusception secondary to pathological lead points (PLPs). METHODS: We conducted a retrospective study of children surgically treated for intussusception between 2010 and 2025. Patients were categorized into PLPs and non-PLPs groups. Demographic, clinical, laboratory, imaging, surgical, and pathological data were compared between the groups. RESULTS: Of 575 children included, 126 (21.9%) had PLPs and 449 (78.1%) were idiopathic. PLPs encompassed a range of etiologies, including Meckel's diverticulum, intestinal duplications, polyps, tumors, and inflammatory conditions. Multivariable logistic regression identified seven independent predictors: older age (OR = 1.023, 95% CI: 1.014-1.032; p < 0.001), the absence of hematochezia (OR = 0.472, 95% CI: 0.268-0.832; p = 0.009), the absence of vomiting (OR = 0.480, 95% CI: 0.242-0.954; p = 0.036), recurrence (OR = 2.313, 95% CI: 1.185-4.513; p = 0.014), small-intestinal intussusception (OR = 2.505, 95% CI: 1.370-4.581; p = 0.003), elevated thrombocytocrit (PCT) (OR = 23.850, 95% CI: 4.902-116.014; p < 0.001), and the presence of ascites (OR = 2.002, 95% CI: 1.209-3.315; p = 0.007). CONCLUSIONS: Older age, hematochezia, vomitus, recurrence intussusception, small-intestinal intussusception, thrombocytocrit and ascites are independent predictors of PLPs and may aid in risk stratification and guide the decision for surgical intervention.