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A new enema for treatment of intussusception with hydrostatic reduction: Olive oil
Burhan Beger1, Ebuzer Duz1, Baran Serdar Kizilyildiz2
1Department of Pediatric Surgery, Van Yuzunciyil University, Van, Turkey.
Insights
Adding olive oil to normal saline for ultrasound-guided hydrostatic reduction (USGHR) of intussusception reduced fluid volume, time, and hospital stays. This improved success rates for pediatric intussusception treatment.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Imaging
Background:
- Intussusception is a common surgical emergency in children.
- Ultrasound-guided hydrostatic reduction (USGHR) using normal saline is the standard treatment.
- Variations in reduction techniques are explored to improve outcomes.
Purpose of the Study:
- To evaluate the efficacy of adding olive oil to normal saline for USGHR in pediatric intussusception.
- To compare outcomes between USGHR with normal saline alone versus a saline-olive oil mixture.
Main Methods:
- Retrospective study of 40 pediatric patients with intussusception.
- Group 1: USGHR with normal saline (n=20).
- Group 2: USGHR with 10% olive oil and 90% normal saline (n=20).
Main Results:
- Group 2 showed significantly lower mean reduction time (12 min vs. 15 min) and fluid volume (58 ml/kg vs. 80 ml/kg) compared to Group 1.
- Fewer recurrent reductions and shorter hospitalisation periods (24 h vs. 38 h) were observed in Group 2.
- Success rates in the first session were higher in Group 2 (19/20) than in Group 1 (14/20).
Conclusions:
- A mixture of olive oil and normal saline is a promising new enema fluid for USGHR.
- This novel approach may increase the success rate of ultrasound-guided reduction for intussusception.
- The findings suggest improved efficiency and patient outcomes with the olive oil-saline mixture.
Objectives:
Intussusception is routinely treated using ultrasound-guided hydrostatic reduction (USGHR) with normal saline in our paediatric surgery department. With this study, olive oil was added to normal saline in ultrasound-guided reduction of intussusception.
Materials And Methods:
Forty patients who were diagnosed and treated for intussusception in Van Yuzuncu Yıl University Faculty of Medicine Pediatric Surgery Department from March 2017 to May 2017 were included in the study. During this retrospective study, randomly chosen 20 patients that treated with USGHR using normal saline were marked as Group 1. Moreover, 20 patients that treated with USGHR using a mixture of olive oil and saline (10% olive oil 90% normal saline) were marked as Group 2. Patients' age, gender, symptoms, treatment techniques, complications and hospitalisation periods were retrospectively noted.
Results:
Forty patients were included in the study. In Group 1, 14 patients were treated in the first session, 4 patients were treated in the second session and 2 patients required laparotomy. Mean reduction time in this group was 15 min mean fluid volume used in each reduction was 80 ml/kg and mean hospitalisation period was 38 h. In Group 2, 19 patients were treated in the first session, and only 1 patient required a second session. Mean reduction time was 12 min, used fluid volume was 58 ml/kg for each reduction and hospitalisation period was 24 h.
Conclusion:
The average volume of fluid used for reduction, average reduction time, numbers of recurrent reductions and hospitalisation were less when a mixture of olive oil and normal saline were used in comparison with when normal saline was used alone to reduction the intussusception under ultrasound guidance. Using olive oil mixed with normal saline as a new enema fluid is likely to increase the success rate of ultrasound-guided reduction of intussusception.
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