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Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
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Esophageal Strictures-II: Clinical Features and Management01:26

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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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Management for intussusception in children.

Steven Gluckman1, Jonathan Karpelowsky, Angela C Webster

  • 1University of Sydney, Sydney Adventist Hospital, Wahroonga NSW 2076, Sydney, Australia.

The Cochrane Database of Systematic Reviews
|June 2, 2017
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Summary
This summary is machine-generated.

This review found low-quality evidence that air enema may be more effective than liquid enema for treating pediatric intussusception. Dexamethasone may reduce recurrence, but more research is needed, especially on surgical interventions.

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Area of Science:

  • Pediatric Gastroenterology and Surgery
  • Clinical Trial Analysis
  • Evidence-Based Medicine

Background:

  • Intussusception is a common pediatric surgical emergency with potential for serious complications.
  • While contrast enema is widely accepted for non-surgical management, optimal techniques and adjuncts remain debated.
  • There is a need to evaluate the safety and effectiveness of various non-surgical and surgical approaches.

Purpose of the Study:

  • To assess the safety and effectiveness of non-surgical and surgical interventions for pediatric intussusception.
  • To synthesize evidence from randomized controlled trials (RCTs) on different management strategies.

Main Methods:

  • Comprehensive search of multiple electronic databases (Cochrane, MEDLINE, Embase, etc.) up to September 2016.
  • Inclusion of all RCTs comparing contrast media, imaging modalities, pharmacological adjuvants, and surgical approaches.
  • Independent study selection, data extraction, and risk of bias assessment; GRADE criteria used for evidence quality evaluation.

Main Results:

  • Six RCTs (822 participants) were included; all had a high risk of bias, resulting in low-quality evidence.
  • Air enema may be more successful than liquid enema for reduction (RR 1.28, 95% CI 1.10-1.49).
  • Dexamethasone as an adjunct may reduce recurrence rates (RR 0.14, 95% CI 0.03-0.60), but its effect on initial reduction is uncertain.

Conclusions:

  • Current evidence quality is low, limiting definitive conclusions on intussusception management.
  • Air enema shows potential superiority over liquid enema, and dexamethasone may help prevent recurrence.
  • Significant gaps exist, particularly the lack of trials evaluating surgical interventions for pediatric intussusception.