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Fluoroscopy-guided hydrostatic reduction of intussusception in infancy: role of pharmacological premedication
Francesco Esposito1, Concetta Ambrosio, Simona De Fronzo
1Department of Radiology, Santobono Children's Hospital, Naples, Italy, fra.in@libero.it.
Insights
Pharmacological premedication significantly increases the success rate of hydrostatic reduction for paediatric intussusception. This approach reduces patient stress, fluoroscopic time, and radiation dose during the procedure.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Emergency Medicine
Background:
- Intussusception is a frequent pediatric emergency.
- Fluoroscopy-guided hydrostatic reduction is a standard nonoperative treatment.
- The benefit of pharmacological premedication for this procedure remains debated.
Purpose of the Study:
- To investigate the correlation between pharmacological premedication and hydrostatic reduction success rates in pediatric intussusception.
- To evaluate the impact of premedication on treatment outcomes.
Main Methods:
- A retrospective study of 398 pediatric patients with idiopathic intussusception treated between 2007 and 2013.
- Comparison of hydrostatic reduction success rates between patients who received no premedication and those who received sedative and anti-oedematous agents.
Main Results:
- The overall success rate for hydrostatic reduction was 65% in the non-premedicated group (n=254).
- In the premedicated group (n=144), the success rate increased to 85%.
- Pharmacological premedication showed a statistically significant improvement in reduction success.
Conclusions:
- Pharmacological premedication is an effective strategy to improve hydrostatic reduction success in pediatric intussusception.
- Premedication helps to minimize patient stress, reduce fluoroscopic exposure time, and lower radiation doses.
Purpose:
Intussusception is one of the most common causes of paediatric emergency. Fluoroscopy-guided hydrostatic reduction is a common nonoperative management strategy for the treatment of intussusception. The role of pharmacological premedication in increasing the success rate of hydrostatic reduction is still controversial. The purpose of this study was to verify the presence of a possible correlation between pharmacological premedication and the percentage of hydrostatic reduction of intussusception in paediatric patients.
Materials And Methods:
This study considered children with a diagnosis of idiopathic intussusception treated at our hospital between January 2007 and June 2013. One group of patients underwent hydrostatic reduction by barium enema without any preliminary therapy. A second group of patients received pharmacological premedication with both a sedative and an anti-oedematous agent before the procedure.
Results:
A total of 398 patients were treated with barium enema for therapeutic purposes. In the group of patients who received no premedication (n = 254), 165 (65 %) children achieved hydrostatic reduction of the intussusception. Among the patients who received pharmacological premedication prior to barium enema (n = 144), 122 (85 %) children achieved resolution of the intussusception.
Conclusions:
Our study shows that the use of pharmacological premedication is effective for the reduction of the intussusception, as its limit patient stress, fluoroscopic time and radiation dose.
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