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Ultrasound guided hydrostatic reduction of intussusception in children by saline enema: our experience
1Pediatric Surgery Unit Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, 605 006 India.
Insights
Hydrostatic reduction using saline enema and ultrasound is a safe and effective treatment for intussusception in children. Older patients and those without ileoileocolic intussusception had higher success rates.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Diagnostic Imaging
Background:
- Intussusception is a frequent cause of acute intestinal obstruction in children.
- Prompt treatment is crucial to prevent severe complications.
Purpose of the Study:
- To assess the efficacy of ultrasound-guided saline enema for hydrostatic reduction of intussusception.
- To identify patient characteristics associated with successful reduction.
Main Methods:
- Retrospective analysis of pediatric intussusception cases from 2000-2007.
- Ultrasound-guided normal saline enema for non-operative reduction in stable patients.
- Surgical intervention was reserved for failed reduction attempts.
Main Results:
- The overall success rate for hydrostatic reduction was 81.37% (83/102 cases).
- Mortality rate was low at 1.2%.
- Ileoileocolic intussusception had a significantly higher failure rate (P=0.0032), while older patients showed significantly higher success rates (P=0.001).
Conclusions:
- Ultrasound-guided hydrostatic reduction with saline enema is an easy, safe, and highly effective treatment for pediatric intussusception.
- Patient age and intussusception type are significant factors influencing treatment success.
Background:
Intussusception is a common cause of acute intestinal obstruction with potentially serious complications. The treatment of choice is an attempt at initial non-operative treatment.
Aim:
The purpose of the study was to evaluate the efficacy of the technique of hydrostatic reduction of intussusception using saline enema and ultrasound being practiced in our institute; the secondary goal was to identify patient subset in which it is more successful.
Material And Methods:
The case records of all patients treated for intussusception in our institute from 1st January 2000 to 30th June 2007 were retrospectively analyzed to collect information. All patients with ultrasound diagnosed intussusception that were not having signs of shock or peritonitis were treated with normal saline enema under ultrasound guidance. Failure of three such attempts was an indication for operation.
Result And Conclusions:
We found that this technique is easy, safe and extremely effective in treating intussusception in children. The success rate was 81.37% (83 out of 102 cases) and mortality rate was 1.2%. Ileoileocolic type of intussusception failed enema reduction more often (statistically significant; P value = 0.0032) while older patients (statistically significant, P value = 0.001) had higher success rates with the technique. Patients who had colocolic type of intussusception (P value = 0.29) and patients who present early (P value = 0.262) appear to have higher success rates but this was not statistically significant.
