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Intussusception: clinical and radiographic factors influencing reducibility
C A Stephenson1, J J Seibert, J D Strain
1Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock.
Insights
Hydrostatic reduction of intussusception using barium or air enema is effective. Distal intussusception and prolonged symptoms reduce success, but complications remain low, even for rectal cases.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Radiology
Background:
- Hydrostatic reduction is a standard treatment for intussusception.
- Evaluating factors influencing reduction success and complications is crucial.
Purpose of the Study:
- To review a five-year experience with hydrostatic reduction of intussusception.
- To compare results with previous studies and evaluate clinical/radiographic factors.
Main Methods:
- Retrospective review of 5-year experience at two children's hospitals.
- Analysis of clinical and radiographic factors impacting reduction rates.
- Comparison of complication rates with prior research.
Main Results:
- Reduction rates decrease with more distal intussusception.
- 25% of rectal intussusceptions reduced without increased complications.
- Small bowel obstruction and prolonged symptoms significantly decreased reduction rates.
- Crescent sign and patient age were not significant factors.
Conclusions:
- Hydrostatic reduction remains a viable treatment for intussusception.
- While distal location and symptom duration impact success, complications are not significantly increased.
- Further investigation into predictive factors for successful reduction is warranted.
Abstract:
Hydrostatic reduction of intussusception by barium or air enema has been widely accepted. The five-year experience with this procedure at two children's hospitals is reviewed and the results compared to previous studies. Various clinical and radiographic factors are evaluated in relation to the reduction rate. The findings show that the more distal the intussusception is encountered, the lower the rate of reduction. However, 25% are reduced within the rectum with no evidence of increased complications. Small bowel obstruction and prolonged duration of signs and symptoms decreased the rate of reduction statistically but there is no significant increase in complication rate in those attempted, contrary to a previous report. The cresent sign (dissection sign) and age of the patient are not significant factors in reduction as reported by other studies.