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Process Management of Intussusception in Children: A Retrospective Analysis in China
Zhihuan Sun1, Guoxin Song, Dandan Lian
1From the Department of Pediatric Surgery, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, China.
Insights
Pediatric intussusception management varies by case complexity. Air enemas and B-ultrasound-guided hydrostatic enemas (B-USGHEs) show similar success rates for single intussusceptions, while cleansing enemas are less effective for multiple cases.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Surgical Outcomes
Background:
- Intussusception is a common surgical emergency in children.
- Effective management strategies are crucial for reducing morbidity.
- Understanding epidemiological factors aids in targeted interventions.
Purpose of the Study:
- To analyze epidemiological features of pediatric intussusception.
- To evaluate the effectiveness of different management strategies.
- To identify factors influencing successful reduction.
Main Methods:
- Retrospective analysis of a hospital database (January 2019 - December 2020).
- Inclusion of demographic data, intussusception size, and treatment methods.
- Comparison of reduction rates for cleansing enemas, air enemas, and B-ultrasound-guided hydrostatic enemas (B-USGHEs).
Main Results:
- 726 children (782 episodes) diagnosed with intussusception; peak onset at 3-4 years.
- Successful reduction rates: single intussusception (cleansing enema 65.25%, air enema 95.80%, B-USGHE 96.04%); multiple intussusceptions (cleansing enema 43.9%, air enema 75%, B-USGHE 57.6%).
- No significant difference between air enema and B-USGHE; diameter and length influenced reduction success (P ≤ 0.05). Recurrence occurred in 7.53% after successful enema reduction.
Conclusions:
- Pediatric intussusception exhibits distinct sex and age onset patterns.
- Cleansing enemas may reduce radiation exposure, particularly for single intussusceptions.
- Air enemas and B-USGHEs demonstrate comparable efficacy; recurrence is often manageable without surgery.
Objectives:
This was a retrospective analysis of the epidemiological features of pediatric intussusception, the effects of different management strategies and the factors affecting successful reduction.
Methods:
Using our hospital database, data on pediatric intussusception from January 2019 to December 2020 were extracted for analysis, including demographic data, size of intussusception, treatment method, and effects.
Results:
The number of children diagnosed with intussusception was 726 (782 episodes). In all, 394 (54.27%) of these children were male. The male to female ratio was 1.19:1. The peak of the onset age was between 3 and 4 years. In the single intussusception group, the successful reduction rate of cleansing enemas was 65.25%, that of air enemas was 95.80%, and that of B-ultrasound-guided hydrostatic enemas (B-USGHEs) was 96.04%. In the multiple intussusceptions group, the successful reduction rate of cleansing enemas was 43.9%, air enemas were 75%, and B-USGHE was 57.6%. There were no significant differences between the air enema and B-USGHE groups. The diameter and length were related factors influencing successful reduction (P ≤ 0.05). Fifty-three (7.53%) children had recurrent intussusception within 4 years, and all of them were following successful enemas. Thirty-one (3.40%) episodes were found to have spontaneously reduced. Five patients (0.7%) underwent surgery after the failure of air enemas or B-USGHE.
Conclusions:
Pediatric intussusception in our region showed a sex ratio difference and age difference of onset. For single intussusceptions and multiple intussusceptions, the successful reduction rate of cleansing enemas means that some children may avoid radiation exposure. The diameter and length of intussusception were related factors influencing successful reduction in cleansing enema. There were no significant differences in successful reduction between air enemas and B-USGHE. Most recurrent intussusceptions can still be reduced, avoiding surgery.
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