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Sonographic guidance of air enema for intussusception reduction in children
1Department of Radiology and Ultrasound, Shanghai Children's Hospital, People's Republic of China.
Insights
Ultrasound (US) can reliably monitor air enema reduction for intussusception in children. This study shows US is a practical and effective tool for confirming successful intussusception reduction.
Area of Science:
- Pediatric Radiology
- Gastroenterology
- Medical Imaging
Background:
- Fluoroscopically guided air reduction is standard for intussusception.
- Limited data exists on using ultrasound (US) to monitor pneumatic reduction.
Purpose of the Study:
- To evaluate the efficacy of US in monitoring air reduction success for intussusception.
Main Methods:
- 199 children underwent sonographically guided air-enema reduction.
- Phase I: US accuracy confirmed by fluoroscopy (11 children).
- Phase II: Reduction success confirmed by clinical improvement and repeat US (188 children).
Main Results:
- US accuracy was confirmed by fluoroscopy in Phase I.
- Initial reduction success rate was 95% in Phase II.
- 92% showed no recurrence on repeat US; 5% required fluoroscopic intervention.
Conclusions:
- Ultrasound-guided air enema is a practical and reliable method for intussusception reduction.
- US offers a safe and effective alternative for monitoring pneumatic reduction.
Background:
Fluoroscopically guided air reduction of intussusception is a well-accepted technique. There are only two previous reports in which US has been used to monitor pneumatic reduction.
Objective:
To assess the ability of US to monitor the success of air reduction of intussusception.
Materials And Methods:
Sonographically guided air-enema reduction of intussusception in 199 children. In phase I (11 children), the success or failure of reduction was confirmed by fluoroscopy. In phase II (188 children), complete reduction was confirmed by clinical improvement of the child and repeat sonography 1 h later showing no persistent intussusception.
Results:
In phase I, fluoroscopy confirmed the accuracy of US in all 11 children. In phase II, the success rate of initial reduction was 95%. Following successful reduction, US repeated 1 h later showed no recurrence of intussusception in 92%. In ten (5%) of 188, initial reduction was unsuccessful; fluoroscopically guided air reduction successfully reduced only three of these ten failures.
Conclusions:
Air enema guided by US is a practical and reliable technique for the reduction of intussusception.