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An experience of ultrasound-guided hydrostatic reduction of intrussusception at a tertiary care centre
M M Ahmad1, M D Wani1, H M Dar1
1Department of Surgery, Government Medical College Srinagar; Karan Nagar, Srinagar, Jammu and Kashmi, India.
Insights
Ultrasound-guided hydrostatic reduction is a safe and effective nonoperative treatment for paediatric intussusception. This method achieved a 90% success rate, making it a recommended first-line management option.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Surgical Procedures
Background:
- Intussusception is a common cause of intestinal obstruction in children.
- Ultrasound-guided hydrostatic reduction offers a nonoperative approach with high success rates.
- This technique is safe, utilizing real-time ultrasound without radiation exposure.
Purpose of the Study:
- To evaluate the efficacy and safety of ultrasound-guided hydrostatic reduction for paediatric intussusception.
- To establish this method as a primary treatment modality.
Main Methods:
- A case study of 89 paediatric patients diagnosed with intussusception via ultrasonography.
- Ultrasound-guided hydrostatic reduction was performed on 78 patients.
- Follow-up ultrasound assessed for recurrence within 24 hours.
Main Results:
- The ileocolic type was most common, prevalent in children aged 6-24 months.
- A 90% success rate (70 of 78 cases) was achieved with complete therapeutic reduction.
- No complications or mortality occurred; recurrences were successfully managed.
Conclusions:
- Ultrasound-guided hydrostatic reduction is a simple, safe, and effective nonoperative treatment for paediatric intussusception.
- This procedure should be considered the first-line management for appropriate patients.
- The technique demonstrates high efficacy and safety in clinical practice.
Background:
Intussusception is an important and one of the most commonly encountered diagnoses of intestinal obstruction in the paediatric age group. Ultrasound-guided hydrostatic reduction is an effective, nonoperative treatment modality for this condition and is associated with a high success rate. In addition, it is simple and safe as the entire procedure is carried out with real-time ultrasound, without the hazard of radiation. The aim of this study was to evaluate the effi cacy and safety of ultrasound-guided hydrostatic reduction in the management of intussusceptions in the paediatric age group.
Method:
A case study was carried out on 89 patients diagnosed with intussusception using high-resolution ultrasonography over a period of two years, spanning February 2012 to January 2014. Ultrasound-guided hydrostatic reduction was performed in 78 of these patients, and 11 patients were excluded owing to clinical contraindications. Follow-up ultrasound was performed after 24 hours to rule out recurrence.
Results:
The disease was most prevalent in the age group 6-24 months. The ileocolic type was the most common. Mean duration (hours) was 17.02 ± 20.81 for time to presentation. Complete therapeutic reduction was achieved in 70 of the 78 cases, with a success rate of 90%. Two recurrences occurred in the following 24 hours, which were successfully reduced on the second attempt. Complications and mortality did not occur secondary to the procedure.
Conclusion:
Our study found that ultrasound-guided hydrostatic reduction is a simple, safe and effective nonoperative treatment for intussusceptions in the paediatric age group, and should be the fi rst line of management in appropriate patients.
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