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Ultrasound-guided Hydrostatic Reduction of Acute Intussusception in Children at a Tertiary Care Center: An
Ajay Kumar Yadav1, Neha Yadav2, Binit Dev1
1Department of Radiodiagnosis and Interventional Radiology, Birat Medical College & Teaching Hospital, Biratnagar, Morang, Nepal.
Insights
Ultrasound-guided hydrostatic reduction is a highly successful treatment for pediatric intussusception, with a 92.85% success rate. This non-surgical approach is effective for bowel obstruction in infants and toddlers.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Diagnostic Imaging
Background:
- Intussusception is a common cause of bowel obstruction in infants and toddlers.
- Ultrasound is the preferred diagnostic tool for intussusception.
- Ultrasound-guided hydrostatic enema reduction is the standard non-surgical treatment.
Purpose of the Study:
- To evaluate the outcome of ultrasound-guided hydrostatic reduction for pediatric intussusception.
- To determine the success rate and recurrence of this procedure.
Main Methods:
- An observational cross-sectional study was conducted.
- Included children with radiologically confirmed intussusception from February 2023 to July 2024.
- Excluded patients with peritonitis; performed ultrasound-guided hydrostatic reduction using normal saline.
Main Results:
- 81 patients (84 intussusceptions) underwent the procedure.
- Successful reduction achieved in 78 cases (92.85%).
- Ileocolic intussusception was most common (88.09%); abdominal pain and vomiting were primary symptoms.
Conclusions:
- Ultrasound-guided hydrostatic reduction demonstrated a high success rate for uncomplicated pediatric intussusception.
- The success rate aligns with previous studies using hydrostatic and pneumatic methods.
- This non-surgical intervention is an effective treatment option.
Introduction:
Intussusception is common cause of acute emergency responsible for bowel obstruction in infants and toddlers with peak age of incidence between 6-9 months. Ultrasound is imaging modality of choice for diagnosis of intussusception and ultrasound guided hydrostatic enema reduction is standard, nonsurgical, internationally preferred treatment modality for uncomplicated pediatric intussusceptions. This study was aimed to find the outcome of the procedure.
Methods:
An observational cross-section was carried in a tertiary care center in children presenting with intussusception. Ultrasoud guided hydrostatic reduction was done in all radiologically confirmed intussusception in children presenting to our tertiary hospital from February 2023 to July 2024 fulfilling the inclusion criteria after proper resuscitation. Patients having marked abdominal distension with features of peritonitis were excluded from the study. Ethical approval was obtained from Institutional Review Committee (Reference number: 287/2023).
Results:
Total 81 patients with 84 intussusceptions underwent ultrasound guided hydrostatic reduction with male to female ratio of 2.86 and mean age 9.49±8.43 months. Hydrostatic reduction was successful in 78 (92.85%) cases. Among successful reductions, 3 (3.84%) patients had recurrence and repeat successful hydrostatic reduction was done. Presenting complain seen were abdominal pain 81 (100%) , vomiting 72 (88.89%). Ileocolic intussusception was seen in 74 (88.09%).
Conclusions:
The success rate of ultrasound-guided hydrostatic reduction using normal saline for uncomplicated intussusception was consistent with findings from previous studies conducted in similar settings, which utilized both hydrostatic and pneumatic reduction methods.
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