Related Experiment Video
Updated: Jun 9, 2025
Chinese Herbal Retention Enema for the Treatment of Ulcerative Colitis
Published on: May 16, 2025
Risk factors of bowel perforation during hydrostatic enema reduction for paediatric intussusception
Xiao Bing Tang1, Shu Ting Liu1, Qian Yun Wu1
1Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, China.
Insights
Bowel perforation during ultrasound-guided hydrostatic enema reduction (UGHR) for intussusception is linked to specific risk factors. Infants under 10.5 months, those with bloody stools, or symptoms over 17.5 hours face increased risk.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Imaging
Background:
- Bowel perforation is a significant complication of ultrasound-guided hydrostatic enema reduction (UGHR).
- Limited research exists on the risk factors and clinical characteristics of bowel perforation during UGHR for pediatric intussusception (P-UGHR).
Purpose of the Study:
- To investigate the risk factors associated with bowel perforation during UGHR for pediatric intussusception.
- To determine the clinical characteristics of patients experiencing bowel perforation during P-UGHR.
Main Methods:
- Retrospective analysis of medical records from January 2011 to December 2021.
- Comparison of patients with P-UGHR versus those without.
- Univariate and multivariate logistic regression to identify risk factors.
Main Results:
- 15 cases of P-UGHR identified out of 4961 intussusception episodes.
- Independent risk factors for P-UGHR included age ≤10.5 months (OR 3.636), bloody stools (OR 4.189), and symptom duration >17.5 hours (OR 0.188).
- Perforations occurred in the ascending (40%), transverse (46.7%), and descending colon (13.3%) without distal necrosis.
Conclusions:
- Age ≤10.5 months, bloody stools, and symptom duration >17.5 hours are significant independent risk factors for P-UGHR.
- Clinical vigilance is advised during UGHR for pediatric patients presenting with these risk factors.
- Further research may elucidate specific mechanisms and preventative strategies for P-UGHR.
Objective:
Bowel perforation is a major, yet unstudied complication of ultrasound-guided hydrostatic enema reduction (UGHR). In this study, we aimed to explore the risk factors and determine the clinical characteristics of bowel perforation during UGHR for paediatric intussusception (P-UGHR).
Methods:
We retrospectively analysed the medical records of patients who underwent UGHR for intussusception at our institution between January 2011 and December 2021. The patients were divided into the P-UGHR and no P-UGHR groups. Univariate and multivariate logistic regression analyses were performed to analyse the risk factors for P-UGHR, and the clinical characteristics of patients with P-UGHR were determined.
Results:
The final analysis included 4961 intussusception episodes. We identified 15 patients [eight male (53.3%); median age, 8.73 months; age range, 3-17 months] with P-UGHR. All P-UGHR cases involved colonic perforations without necrosis distal to the intussusception mass. The perforations were located in the ascending [40% (6/15)], transverse [46.7% (7/15)] or descending colon [13.3% (2/15)]. Age ≤10.5 months [odds ratio (OR), 3.636; 90% confidence interval (CI), 1.274-10.38; P = 0.043], bloody stools (OR, 4.189; 90% CI, 1.352-12.978; P = 0.037) and symptom duration >17.5 h (OR, 0.188; 90% CI, 0.053-0.666; P = 0.03) were independent risk factors for P-UGHR.
Conclusion:
Age ≤10.5 months, bloody stools and symptom duration >17.5 h were independent risk factors for P-UGHR. Caution should be exercised during UGHR in patients aged ≤10.5 months, with bloody stools or symptom duration >17.5 h.
Related Concept Videos
01:22Esophageal Perforation-I: Introduction
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
01:23Lower GI Series: Barium Enema
Procedure Details
The examination begins by inserting a lubricated rectal tube into the patient's rectum to administer a radiopaque barium solution. The barium flow is carefully...
01:25Assessment of the Rectum and Anus
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
01:28Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...