781 Surgical Management of Paediatric Intussusception in Sub-Saharan Africa: A Systematic Review

Abstract Aim Paediatric intussusception remains the leading cause of intestinal obstruction among infants and children globally. While non-operative management predominates in high-income settings, surgery remains the mainstay in Sub-Saharan Africa (SSA) due to limited diagnostic infrastructure and delayed presentation. Despite high disease burden, regional surgical outcomes have not been systematically evaluated. This study aims to assess the surgical management and outcomes of paediatric intussusception across SSA, highlighting opportunities for improved care. Method PubMed, Google Scholar, and African Journals Online (AJOL) were searched for studies reporting surgical outcomes in paediatric population within SSA. Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. Data were extracted on surgical modality and indications, postoperative outcomes, contributing factors to morbidity and mortality. Results Twenty-nine studies spanning 11 SSA countries and 4,429 patients (2001- 2024) were included. Manual reduction was attempted in most cases with variable success rates (9-91%). The universal surgical approach was open, with laparoscopy reported in only two studies. Bowel resection was required in 9-70% of patients, primary anastomosis preferred over stoma formation. Postoperative mortality ranged from 1-35%, the mean mortality rate (≈16%) was markedly higher than in high-income countries (< 1%). Conclusions Surgical management of paediatric intussusception in SSA is dominated by open procedures and characterised by high rates of bowel resection and mortality. Late presentation, bowel resection and sepsis remain the key predictors of poor outcomes. Strengthening early diagnostic capacity, expanding access to non-operative reduction techniques, and investing in paediatric surgical infrastructure and training are urgently required to reduce preventable deaths.