Related Experiment Videos
An analysis of bowel perforation in patients with intussusception
Insights
Barium enemas are effective for diagnosing and treating intussusception in children. Bowel obstruction or young age do not contraindicate this procedure, with perforation being the only major exclusion.
Area of Science:
- Pediatric Radiology
- Gastrointestinal Surgery
- Medical Imaging
Background:
- Intussusception is a common surgical emergency in children.
- Barium colon examinations are frequently used for diagnosis and reduction.
- Contraindications for barium studies in intussusception require clarification.
Purpose of the Study:
- To evaluate the safety and efficacy of barium colon examinations for intussusception in children.
- To determine if bowel obstruction or age are absolute contraindications.
- To identify the primary contraindication for barium studies in pediatric intussusception.
Main Methods:
- Retrospective review of 40 pediatric patients with intussusception.
- Analysis of radiographic findings, including small bowel obstruction.
- Correlation of clinical presentation, operative findings, and procedural outcomes.
Main Results:
- Barium studies were successfully used for diagnosis and reduction in children younger than six months, even with obstruction.
- Five children over six months had perforations discovered at surgery; three had radiographic evidence of small bowel obstruction.
- Hydrostatic reduction was successful in some children with evidence of small bowel obstruction.
Conclusions:
- Barium colon examination is a valuable tool for pediatric intussusception, with perforation as the main contraindication.
- Radiographic evidence of bowel obstruction and age less than six months are not absolute contraindications.
- Careful patient selection is crucial, prioritizing perforation as the key exclusion criterion.
Abstract:
A barium colon examination is recommended for the diagnosis and reduction of intussusception in children, except when bowel perforation is evident either radiographically or clinically. In our experience and contrary to recent reports neither radiographic evidence of bowel obstruction nor an age of less than six months is a contraindication. We reviewed 40 patients diagnosed as having had intussusception and found five children aged more than six months with perforations discovered at operation. Three of the five children had plain radiographic findings of small bowel obstruction as did nine other children. In four of the 12 children with evidence of small bowel obstruction a successful hydrostatic reduction of the intussusception was carried out. Barium studies were performed for diagnosis and therapy in eight children with ileo-colic intussusception aged six months or less, four of whom had evidence of small bowel obstruction. In five, including two with obstruction, reduction of the intussusception was successful. The major contraindication to barium examination is radiographic or clinical evidence of perforation.