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Predictors of Failure in Ultrasound-Guided Hydrostatic Reduction of Intussusception in Children: Retrospective
Belachew Dejene Wondemagegnehu1, Ephrem Nidaw Kerego2, Tihtina Negussie Mammo1
1Department of Surgery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Insights
Currant jelly stool, ileo-ileo colic intussusception, pathologic lead point, and abdominal distention predict failed ultrasound-guided hydrostatic reduction in children. These factors are crucial for identifying cases likely to require alternative interventions.
Area of Science:
- Pediatric Gastroenterology
- Medical Imaging
- Surgical Outcomes
Background:
- Intussusception is a common surgical emergency in children.
- Ultrasound-guided hydrostatic reduction is a primary treatment modality.
- Predicting reduction failure is essential for timely intervention.
Purpose of the Study:
- To identify key predictors of failed ultrasound-guided hydrostatic reduction in pediatric intussusception.
- To improve patient management by understanding factors associated with treatment failure.
Main Methods:
- Retrospective review of 174 children undergoing ultrasound-guided hydrostatic reduction.
- Analysis of demographic, clinical, and sonographic findings using logistic regression.
- Inclusion of variables such as intussusception type, lead point, and stool characteristics.
Main Results:
- The overall success rate for hydrostatic reduction was 81.6%.
- Significant predictors of failure included currant jelly stool, ileo-ileo colic intussusception, pathologic lead point, and abdominal distention.
- Factors like sex, vomiting, diarrhea, and lymph nodes showed no association with reducibility.
Conclusions:
- Currant jelly stool, ileo-ileo colic intussusception, pathologic lead point, and abdominal distention are critical predictors of failed hydrostatic reduction.
- These findings aid in clinical decision-making for pediatric intussusception management.
- Early identification of these predictors can guide surgical planning and improve outcomes.
Purpose:
To identify factors predicting the failure of ultrasound-guided hydrostatic reduction of intussusception in children.
Patients And Methods:
The medical records of 174 children who underwent ultrasound-guided hydrostatic reduction of intussusception over four years were reviewed at Tikur Anbessa Specialized Hospital. Patient's demography, clinical data, and sonography findings (type of intussusception, length of intussusception, presence of lead point, trapped fluid, lymph node, and free peritoneal fluid) were entered into SPSS 25 (IBM) and analyzed using logistic regression.
Results:
The overall success rate of ultrasound-guided hydrostatic reduction was 81.6%. The sex, presence of abdominal cramps, vomiting, diarrhea, trapped lymph nodes on ultrasound, or history of upper respiratory tract infection had no association with hydrostatic reducibility. Currant jelly stool (OR 0.128; 95% CI, 0.27-0.616; P=0.01), Ileo-ileo colic intussusception (OR 0.055; 95% CI, 0.005-0.597; P=0.017), pathologic lead point (OR 0.66; 95% CI, 0.01-0.447; P=0.005) and abdominal distention (OR 0.209; 95% CI, 0.044-0.998; P=0.048) showed significant association with failed hydrostatic reduction.
Conclusion:
The presence of currant jelly stool, ileo-ileo colic type intussusception, pathologic lead point, and abdominal distention are the most important predictors for failed ultrasound ultrasound-guided reduction intussusception in children.
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