Rebound of pediatric idiopathic ileocolic intussusception following the COVID-19 pandemic: a longitudinal follow-up study.

backgroundSocial distancing during the coronavirus disease 2019 (COVID-19) pandemic was associated with a marked decline in pediatric idiopathic ileocolic intussusception, consistent with the well-known role of infection in this condition. Whether intussusception rates have rebounded following the lifting of pandemic-related restrictions remains unknown.

objectiveTo determine whether the rate of pediatric idiopathic ileocolic intussusception returned to pre-pandemic levels after the relaxation of social distancing measures, using hypertrophic pyloric stenosis (HPS) as a control. MATERIALS AND

methodsWe retrospectively reviewed air contrast enemas performed for idiopathic ileocolic intussusception at a single tertiary pediatric center from April 2016 through March 2026. Cases were categorized as pre-pandemic (April 2016-March 2020), pandemic (April 2020-March 2021), and post-pandemic (April 2022-March 2026). The 2021-2022 transitional year was excluded because the regional state of emergency ended during that interval, limiting its interpretability. Annualized case counts were compared across the prespecified periods using an exact conditional Poisson test with Garwood 95% confidence intervals (CIs).

resultsIn the pre-pandemic period, idiopathic ileocolic intussusception occurred at a mean of 31.5 cases/year (95% CI 26.2-37.5). During the pandemic, the rate decreased to a mean of 11 cases/year (95% CI 5.5-19.7), a 65% decrease (P<0.001). During the post-pandemic period, the mean rate was 38.5 cases/year (95% CI 32.7-45.1), a 250% increase relative to the pandemic period (P<0.001), and was not significantly different from the pre-pandemic rate (P=0.11), indicating a return to baseline. In contrast, HPS rates were 46.8 cases/year pre-pandemic (95% CI 40.3-54.0), 43 cases/year during the pandemic (95% CI 31.1-57.9), and 33.5 cases/year post-pandemic (95% CI 28.1-39.7), with no significant change from the pre-pandemic to the pandemic period (P=0.68) or from the pandemic to the post-pandemic period (P=0.16). A modest decline was observed when the post-pandemic period was compared to the pre-pandemic period (P=0.004). Across the study, the intussusception cohort comprised 126 male and 61 female patients (mean age 1.94 years, range 0.13-8 years) and the HPS cohort 140 male and 31 female patients (mean age 0.11 years, range 0.03-0.25 years).

conclusionIdiopathic ileocolic intussusception demonstrated a statistically significant decline during the COVID-19 pandemic and rebounded to baseline in the post-pandemic period. The decline and subsequent recovery of intussusception temporally coincided with the imposition and relaxation of social distancing measures.