Ultrasound-guided Hartmann's solution enema: first-choice procedure for reducing idiopathic intussusception

Area of Science:

• Pediatric Gastroenterology
• Medical Imaging
• Surgical Procedures

Background:

• Idiopathic ileocecocolic intussusception is a common pediatric surgical emergency.
• Enema reduction is a standard treatment, with both ultrasound-guided and radiological methods employed.
• Comparing the efficacy and safety of these two enema techniques is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the effectiveness of ultrasound-guided Hartmann's solution enema (US-E) and radiological liquid enema (RX-E) in reducing idiopathic ileocecocolic intussusceptions.
• To evaluate the influence of patient age and symptom duration on the success rates of both enema methods.

Main Methods:

• A study involving 42 patients with idiopathic ileocecocolic intussusception.
• Patients were treated with either US-E (20 patients) or RX-E (23 patients).
• Subgroup analysis based on age (<6 months, 6-12 months, >12 months) and symptom duration (<12 h, 12-24 h, >24 h).

Main Results:

• Complete reduction was achieved in 75% of US-E cases versus 43.5% of RX-E cases (p=ns).
• US-E demonstrated a significantly higher success rate in patients over 12 months (p=0.0063) and with symptom duration over 24 hours (p=0.0361).
• No significant differences in success rates were observed in other subgroups, and no complications were reported for either method.

Conclusions:

• Both US-E and RX-E are safe and effective for reducing idiopathic intussusception.
• US-E appears more effective in patients older than 12 months and those with symptom duration exceeding 24 hours.
• Given its avoidance of radiation, US-E is recommended as the preferred initial procedure, especially for these specific patient subgroups.