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Intussusception in children: US-guided pneumatic reduction--initial experience
1Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-dong, Songpa-ku, Seoul 138-736, South Korea. chyoon@www.amc.seoul.kr
Insights
Ultrasonography-guided pneumatic reduction is a feasible and effective treatment for intussusception in children. This radiation-sparing method achieved a high success rate with no immediate recurrence in the study.
Area of Science:
- Pediatric surgery
- Medical imaging
- Gastroenterology
Background:
- Intussusception is a common surgical emergency in children.
- Pneumatic reduction is a standard treatment, but often relies on fluoroscopy.
- Minimizing radiation exposure in pediatric procedures is a clinical priority.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of ultrasonography (US)-guided pneumatic reduction for pediatric intussusception.
- To assess the success rate and safety of this radiation-free approach.
Main Methods:
- A prospective study of 49 children (2 months to 7 years) undergoing 52 US-guided pneumatic reductions.
- Intussusception diagnosed via US criteria; reduction performed entirely within the US suite.
- Initial reduction at 60 mm Hg, repeated at 120 mm Hg if unsuccessful, with US monitoring.
Main Results:
- High overall success rate of 92% (48/52 reductions) with no immediate recurrence.
- Two cases were irreducible, with one revealing a lead point (polyp) and the other residual intussusception.
- Two perforations (4%) occurred, one requiring hemicolectomy and the other manual reduction.
Conclusions:
- US-guided pneumatic reduction is a feasible and effective treatment for pediatric intussusception.
- The method offers a significant radiation-sparing benefit.
- High success rates support its use as a primary intervention.
Purpose:
To assess the feasibility and effectiveness of ultrasonography (US)-guided pneumatic reduction of intussusception in children.
Materials And Methods:
The study group consisted of 49 consecutive patients (aged 2 months to 7 years; 36 boys, 13 girls) who underwent 52 reductions of intussusception during 9 months. Intussusception was diagnosed in all patients with the known US criteria, and all patients underwent a US-guided pneumatic reduction attempt wholly within the US examination room. A pressure of 60 mm Hg was maintained for 30 seconds, with US guidance. The procedure was considered to be successful when US showed the disappearance of the intussusceptum and the edematous terminal ileum with an abrupt transition into the normal proximal ileum. When the intussusception was not reduced, the procedure was repeated, with pressure increased to 120 mm Hg.
Results:
The overall success rate of US-guided pneumatic reduction was 92% (48 of 52 reductions), with no immediate recurrence. Of the two patients who had intussusceptions that were irreducible, one had residual ileoileal intussusception at surgery, and the other had an ileal polyp as a lead point. Perforation occurred in two (4%) of 52 cases; one patient underwent right hemicolectomy due to bowel necrosis and had a pinpoint perforation in the normal proximal transverse colon, and the other underwent manual reduction of ileoileocolic intussusception, with microperforation in the proximal transverse colon.
Conclusion:
US-guided pneumatic reduction seems to be a feasible and effective method for the treatment of intussusception in children because of its radiation-sparing effect and high success rate.