DISCUSSION continues at the present time as to the best means of dealing with the young child who has an irreducible or gangrenous segment of ileum or cecum resulting from intussusception. Three methods are employed and are still debated: (1) primary resection and anastomosis; (2) two-stage resection and anastomosis (Mikulicz), and (3) lateral anastomosis leaving the intussusception in situ.
Primary resection and anastomosis is obviously the ideal method of treatment if it can be performed safely, but before accepting it as the routine treatment it is advisable to consider the problem in two ways:
1. The local hazard: the technical difficulties and risks involved in anastomosing the bowel immediately after excision of the infarcted or gangrenous segment.
2. The general hazard: the state of illness of the child.
The first danger is not insuperable. The literature contains several accounts of single cases in which primary resection and anastomosis has succeeded