Hydrostatic Reduction With Barium Enema Is A Preferred Treatment Option for Uncomplicated Intussusception : Five Years Experience in Cmch (original) (raw)
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Hydrostatic Reduction for Intussusception in Children: A Safe Method in Uncomplicated Cases
IOSR Journals , 2019
Introduction: Hydrostatic reduction under ultrasound guidance is a well-recognized alternative method for reduction of childhood intussusceptions. The various forms of enema in use for ultrasound guided liquid enema in use include portable tap water, normal saline or Ringers lactate solution. we did hydrostatic reduction of childhood intussusception using saline under US guidance, Material &Methods: This prospective study was conducted in Government Generai Hospital, Srikakulam during December 2017 to April 2019. The children who presented with excessive cry and red current jelly stools and nausea were admitted and investigated. Results: The present study conducted over a period of 16 months in a tertiary care hospital, a total number of 25 cases were presented with male preponderance. Their age ranged from 6 months to 36 months with a mean age of 9.8 ± 8.5. The duration of symptoms ranged from 4 h to 96 h with a mean of 32.5 ± 25.8 h.The most common symptoms being colicky abdominal pain (100.0%),vomiting (78%), and palpable abdominal mass (68%). Two patients (8%) had recurrent intussusception during follow up. at an interval of 1 to2 months after initial reduction. The duration of the procedure ranged between 8 min to 20 min, with a mean of12.0 ± 3.5 min. The mean duration of admission between those who had successful reduction was 1.5 ± 0.3 days There was no mortality in our series. Conclusion: Hydrostatic reduction of intussusception under real time ultrasound with normal saline enema is a suitable non-operative technique of managing childhood intussusception with a success rate of 88%.
Multimodalities of Management of Paediatric Ileocolic Intussusception
Journal of Evolution of Medical and Dental Sciences, 2015
Intussusception is a life-threatening illness and occurs when a portion of the intestine folds like a telescope with one segment slipping inside another segment. Hirschsprung was the first to publish a series of reports on successful hydrostatic reduction in 1876. Intussusception remains one of the most commonly encountered paediatric surgical emergencies. Enema reduction still remains the mainstay of non-operative care today. Barium and more recently air contrast enemas have been the initial diagnostic and therapeutic investigation of choice. Successful reduction rates vary widely from 42 to 95% (eee). AIMS AND OBJECTIVES: Aims and objectives of this article with a series of cases of intussusception is to review the various clinical presentation and to study the effectiveness of non-surgical intervention using contrast or AIR enema reduction under fluoroscopic guidance. METHODS AND RESULTS: A prospective study from October 2010 to September 2015 was carried out in hospitals in Bangalore. Complete review of medical records for clinical and demographic information was only performed for those cases fulfilling diagnostic criteria. During the study, A total of 62 patients diagnosed cases were included in this study. Cases identified in the study were similar in presentation and demographics as those observed in other South Asian Countries. These patients were haemodynamically stabilized and were subjected to definitive procedure; enema reduction was tried in all patients. Multimodalities of management included nonoperative reduction that is hydrostatic enema reduction in 2 cases (3.2), barium enema reduction 45 cases (72.5) and air enema recution in 12 cases (19.3), finally 3 cases (4.8) which failed enema reduction were operated. One case (1.61) intussusception-associated death was recorded. CONCLUSION: Surgical intervention in intussusception can be prevented by nonoperative reduction, especially if presented early and no signs of peritonitis.
PubMed, 2022
Introduction: Intussusception is a medical emergency caused by proximal insertion of the intestinal segment to its lumen, which results in ischemia, necrosis, and sepsisassociated mortality in pediatric patients. Intussusception is managed mainly by surgical reduction; hydrostatic reduction is a noninvasive alternative with lower risk of complications. The study was aimed to analyze the risk factors for the failure of hydrostatic reduction in children with intussusception at the Hasan Sadikin General Hospital. Materials and methods: The medical records of children diagnosed with intussusception and treated with hydrostatic reduction during January 2010 and September 2019 were included. Variables of the study included age, sex, onset of symptoms, and outcome. Logistic regression analyses were performed to determine the significance and strength of correlation on the included characteristics with outcomes of hydrostatic reduction in the population. The p < 0.05 was deemed significant. Results: There were a total of 56 children with intussusception who were treated with hydrostatic therapy during the study period. The failure rate of hydrostatic therapy was 83.9%. Age, sex, onset of symptoms, and location of intussusception were not significantly associated with the failure of hydrostatic reduction (p > 0.05). Dehydration was the only symptom significantly associated with the failure of hydrostatic reduction (OR 16.80; p = 0.001). Conclusion: Dehydration is significantly associated with the failure of hydrostatic reduction in children with intussusception.
Journal of the Ruhunu Clinical Society
Introduction: A retrospective study was done to assess the efficacy of saline reduction without radiological guidance for uncomplicated intussusceptions at a tertiary care children's hospital from April 2014 to May 2015. Methods: Clinical records of consecutively admitted 103 children were analysed. Results: 85 children were successfully treated with a single attempt of saline reduction while another 11 patients were successfully managed with second or third attempt of saline reduction. Only seven children needed laparoto my. Overall success rate of the procedure in this sample was 93.2%. Conclusions: Hydrostatic reduction can be used effectively and safely in the absence of ultrasound facilities to manage uncomplicated intussusceptions.
Outcome of ultrasound guided reduction of intussusception in children by saline enema
International Surgery Journal
Background: Intussuception is a common cause of acute intestinal obstruction in children and contributor of morbidity and mortality in children. The purpose of this study was to evaluate efficacy of hydrostatic reduction of intussusception over operative reduction using normal saline enema in children and to identify procedure related complications.Methods: All patients presenting to us with features of intussusception clinically and confirmed by ultrasonography between June 2015 to November 2017 were included in study. Depending on haemodynamic stability of patient and surgeon’s preference, patients were subjected to trial of hydrostatic reduction by normal saline enema or operative procedure. Patients with failure or partial reduction were taken for surgery.Results: The mean age was 21.07 months with a male preponderance. Of 53 patients attending the institute, 32 were given a trial of hydrostatic reduction which was successful in 28. Thus success rate was 87.5%. 1 patient succumb...
Ultrasound-Guided Hydrostatic Reduction of Childhood Intussusceptions Using Water Enema
Iranian Journal of Medical Sciences, 2006
Conventional hydrostatic barium reduction or pneumatic reduction of intussusception is associated with considerable ionizing radiation. The aim of this study was to evaluate ultrasound-guided hydrostatic reduction for childhood intussusception using water enema. A total of 76 children who diagnosed as having intussusception were referred to Doctor Sheikh Children Hospital in Mashhad (northeast Iran) during a 4.5-year period from March 2002 to September 2006. Hydrostatic reduction of intussusception was performed under sonographic guidance in 66 patients, whereas, 10 patients were excluded due to clinical contraindications. The disease was observed mostly at the age of 5-9 months. In 53% of patients, there was a recent history of gastroenteritis or common cold. The most common site of intussusception was the transverse colon (49%) with the mean duration of 22.1±17.3 hours. The overall rate of successful reduction was 78.8% and the mean reduction time of 14.8±18.56 minute. The successful reduction rate would have been 94.5%, if the patients with gangrene were excluded. We conclude that ultrasound-guided hydrostatic reduction using water enema is an optimal, simple, and safe procedure for the treatment of childhood intussusception
https://www.ijrrjournal.com/IJRR\_Vol.9\_Issue.1\_Jan2022/IJRR-Abstract034.html, 2022
Background: Intussusception is one of the most frequent causes of acute bowel obstruction in infants and toddlers. Abdominal sonogram is highly specific, accurate and is the first line diagnostic modality. The primary treatment options are non-operative hydrostatic or pneumatic reduction. In our institution, we use normal saline for reduction of intussusception under ultrasound guidance (USGR). The aim of the study is to analyse the clinical pattern and treatment outcome of intussusception. Methodology: Retrospective analysis of all cases admitted with intussusception in our department during 2014-2018 was done. Results: 785 cases (527 males: 258 females) with a mean age of 25 months and median of 16 months had abdominal pain (92.5%), vomiting (59%) and blood in stools (32%) as the predominant symptoms. 710/785 cases (90.4%) underwent successful USGR and 75/785 of the failed cases underwent surgery. Age group < 12 months, presence of blood in stools irrespective of its duration and prolonged vomiting >48 hours were found to be significant factors for failed USGR. Vomiting and blood in stools were found to be significantly higher in children <12 months of age (p<0.005), whereas pathological lead points were more frequent in children >3 years of age. Conclusion: With a high success rate and no significant complication rate, USGR is an effective non-operative treatment modality for intussusception. Age group <12 months, prolonged vomiting and presence of blood in stool were found to affect the success rate of hydrostatic reduction.
Indications for repeated enema reduction of intussusception in children
Srpski arhiv za celokupno lekarstvo, 2014
Introduction. Intussusception is a common abdominal emergency in early childhood. It is idiopathic in more than 90% of cases with incidence of 1.5-4 per 1,000 live births. The treatment of choice is nonoperative hydrostatic or air enema reduction. Objective. The aim of the study was to evaluate the influence of clinical presentation and symptom duration in non-operative treatment, considering the indications for delayed enema reduction and its efficacy. Methods. From the total number of 107 patients with intusussception, aged from 2 months to 14 years (median 9 months), 102 (95%) patients with ileo-colic intussusceptions were treated initially by ultrasound guided saline enema. Records were reviewed for patients with failed initial treatment and delayed repeated enemas or operative procedure. The predictor variable included duration of presenting symptoms. Results. Successful treatment by hydrostatic saline enemas had 58/102 (57%) patients. Success in reduction was greater if sympto...
Intussusception in children: not only surgical treatment
Journal of Pediatric and Neonatal Individualized Medicine, 2017
Introduction: Intussusception is the commonest cause of acute intestinal obstruction in children. Failure of timely diagnosis and treatment results in a surgical emergency leading to fatal outcome. The classic triad of symptoms is seen in less than one-third of the children affected. Aim of this study was to evaluate the comprehensive management of intussusception in children, evaluating the outcome of conservative treatment with hydrostatic ultrasound reduction and surgery. Material and methods: A retrospective analysis was conducted including pediatric patients (up to 14 years old) with diagnosis of bowel intussusception. The management and treatment depended on the patients’ situation: for children in good general conditions initial hydrostatic reduction under continuous ultrasonographic monitoring was attempted; if severe dehydration and/or septic shock was observed, the conservative treatment was contraindicated and direct surgical treatment was performed. Result: A total of 4...