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Pneumatic reduction of intussusception: 5-year experience
M Stein1, D J Alton, A Daneman
1Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Ont, Canada.
Radiology
|June 1, 1992
Summary
Pneumatic reduction successfully treated 80.9% of pediatric intussusceptions. This method is a viable alternative to barium reduction, though predictors of failure and perforation were identified.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Imaging
Background:
- Intussusception is a common surgical emergency in infants and children.
- Traditional barium reduction carries risks and limitations.
- Pneumatic reduction offers a potentially safer and effective alternative.
Purpose of the Study:
- To evaluate the efficacy and safety of pneumatic reduction for pediatric intussusception.
- To identify predictors of successful reduction, failure, and complications.
- To compare pneumatic reduction with barium reduction in managing intussusception.
Main Methods:
- A retrospective review of 246 pneumatic reduction attempts in 219 pediatric patients over 5 years.
- Analysis of patient demographics, procedure outcomes, fluoroscopy times, and complications.
- Logistic regression analysis to identify independent predictors of reduction failure and bowel perforation.
Main Results:
- Successful reduction was achieved in 80.9% of cases.
- Complications included bowel perforation in 2.8% of cases.
- Recurrence occurred in 11% of cases. Predictors of failure included ileoileocolic intussusception, prolonged symptoms, rectal bleeding, and prior failed barium reduction. Younger age and prolonged symptoms predicted perforation.
Conclusions:
- Pneumatic reduction is an effective and safe primary treatment for pediatric intussusception.
- Long duration of symptoms is the most significant predictor of poor outcomes.
- Pneumatic reduction serves as a valuable substitute for barium in managing pediatric intussusception.