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Barium enema reduction of intussusception in a developing country
R Tota-Maharaj1, B Rampersad, R Indalsingh
1Department of Paediatric Surgery, Eric Williams Medical Sciences Complex, Mt. Hope, Trinidad and Tobago, West Indies. rajtota@hotmail.com
Objective:
To determine the current success rate of barium enema reduction of intussusception and to investigate the factors affecting successful reduction.
Design And Methods:
All patients admitted to the Eric Williams Medical Sciences Complex during the 8-year period from January 1, 2000 to December 31, 2007 with a diagnosis of intussusception were included. Patients' demographics, date and time of admission, clinical features, success of barium reduction, surgical findings and length of stay were recorded. The SPSS 12.0 programme was used for data analysis.
Results:
There were 65 cases of intussusception. Vomiting and rectal bleeding were the most common presenting symptoms (55, 85% / 49, 75%). Fifty-eight patients underwent barium enema reduction with 41.4% (24/58) having successful reduction. Factors which significantly increased the success rate included males older than 12 months, non-opioid analgesia or no analgesia and an admission to enema reduction time of less than 6 hours.
Conclusion:
The successful reduction rate is relatively low (41%). A higher index of suspicion is needed in order to make a timely diagnosis and institute appropriate treatment quickly.
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