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Intraoperative hydrostatic reduction of intussusception.

Uday Sankar Chatterjee1, Ajoy Ghosh, Ashoke Kumar Basu

  • 1Department of Pediatric Surgery, Park Children's Centre for Treatment and Research, 4 Gorky Terrace, Kolkata - 700 017, India.

Journal of Indian Association of Pediatric Surgeons
|December 17, 2009
PubMed
Summary

This study introduces a simpler method for reducing intussusception during open surgery using hydrostatic pressure from saline infusion. This technique aims to minimize bowel injury and avoid unnecessary surgical interventions.

Keywords:
Fluoroscopyhydrostatic reductionintussusceptionprimary laparotomyultrasonography

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Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Surgery

Background:

  • Intussusception is a common surgical emergency in infants.
  • Traditional reduction methods can be challenging and risk bowel injury.

Purpose of the Study:

  • To evaluate a novel, non-invasive hydrostatic pressure technique for intussusception reduction during open surgery.
  • To reduce the incidence of bowel injury and unnecessary resection and anastomosis.

Main Methods:

  • Warm normal saline infusion via a Foley catheter before laparotomy.
  • Application of diffuse hydrostatic pressure to the saline-filled colon distal to the intussusception.
  • Procedure performed when imaging modalities were unavailable.

Main Results:

  • Six pediatric patients (mean age 11 months) were treated.
  • Successful reduction was achieved in all cases where intussusception was present at laparotomy.
  • Two cases showed spontaneous reduction prior to surgical intervention.

Conclusions:

  • Hydrostatic pressure offers a safer and more consistent method for intussusception reduction compared to manual manipulation.
  • This technique can be particularly beneficial for less experienced surgeons.
  • It effectively avoids the need for intestinal resection and anastomosis in many instances.