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Ultrasound-guided Saline Hydrostatic Reduction in Pediatric Intussusception - Experience from a Tertiary Care Center
S Soundharya1, Sandesh V Parelkar1, Beejal V Sanghvi1
1Department of Paediatric Surgery, Seth GSMC and KEM Hospital, Mumbai, Maharashtra, India.
Insights
Ultrasound-guided saline hydrostatic reduction (SHR) is a highly effective, nonoperative treatment for intussusception in children, achieving a 90.2% success rate. Early presentation significantly improves outcomes for this common pediatric intestinal obstruction.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Imaging
Background:
- Intussusception is a frequent cause of acute abdomen and intestinal obstruction in infants and children.
- Prompt management is crucial to prevent bowel vascular compromise.
- Ultrasound-guided saline hydrostatic reduction (SHR) offers a nonoperative approach for stable, uncomplicated cases.
Purpose of the Study:
- To evaluate the success rates of ultrasound-guided SHR for intussusception.
- To determine if patient age, symptom duration, or intussusception site correlates with reduction success.
Main Methods:
- A retrospective study was conducted over three years at a tertiary care center.
- Included 103 pediatric patients who underwent attempted SHR; those directly operated on were excluded.
- Demographic and clinical data were collected and statistically analyzed.
Main Results:
- Successful reduction was achieved in 90.2% of patients (93 out of 103).
- No significant correlation was found between SHR success and patient age or intussusception site.
- Patients presenting with shorter symptom durations had higher success rates.
Conclusions:
- Ultrasound-guided SHR is an effective and safe nonoperative treatment for pediatric intussusception.
- Success rates are high (90.2%) in clinically stable children, regardless of age or location.
- Early symptom presentation is associated with improved outcomes for SHR.
Context:
Intussusception is one of the most common causes of acute abdomen and intestinal obstruction in infants and children which requires emergent management to avoid vascular compromise to the bowel. Ultrasound-guided saline hydrostatic reduction (SHR) is a nonoperative technique used in its management which can avoid surgery in a clinically stable and uncomplicated child.
Aims:
The aim of this study was to assess the success rates of SHR in a tertiary care center and also to assess any relationship between success of reduction with age of patient, duration of symptoms, and site of intussusception.
Settings And Design:
This was a retrospective study conducted in a single tertiary care center for 3 years.
Materials And Methods:
All patients who had undergone an attempt at hydrostatic reduction were included in the study. Children who directly underwent surgery were excluded from the study. All pertinent demographic and clinical data were collected from the medical records department, tabulated, and analyzed.
Statistical Analysis:
Statistical testing was conducted with SPSS Statistics 23.0.
Results:
Among a total of 103 patients, 93 underwent successful reduction (90.2%). The comparison between success of reduction with age of patients or with site of intussusception was not significant. Success of reduction was also compared with the duration of symptoms at presentation, with increased success seen in early presenters.
Conclusions:
Ultrasound-guided SHR of intussusception is an effective method with success rates of 90.2% and can be safely implemented in children who are clinically stable, irrespective of age and site, with increased success seen in early presenters.
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