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[Treatment of intestinal invagination with particular emphasis on reduction by colonic insufflation. Report on 5110
Insights
Colonic insufflation is a safe and effective non-surgical treatment for intussusception in infants and children. This method significantly reduces the need for surgery, lowering associated mortality and morbidity.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Intussusception is a common surgical emergency in infants and children.
- Traditional treatments often involve surgery, carrying significant risks.
Purpose of the Study:
- To evaluate the efficacy and safety of colonic insufflation for intussusception reduction.
- To compare colonic insufflation with other treatment methods.
Main Methods:
- Analysis of 5110 cases of intussusception treated over 21 years.
- Detailed description of the colonic insufflation technique, including indications and contraindications.
- Presentation of a novel air insufflation apparatus with pressure control.
Main Results:
- Colonic insufflation achieved a 94.98% success rate in 4841 cases.
- Significantly lower rates of surgery (512/5110 cases) were required.
- Common symptoms included abdominal pain, vomiting, bloody stools, and a palpable abdominal mass.
Conclusions:
- Colonic insufflation is a highly effective, low-cost, and minimally invasive treatment for intussusception.
- This method reduces the need for surgical intervention, thereby decreasing mortality and morbidity.
- Ambulatory reduction of intussusception via colonic insufflation is feasible.
Abstract:
The author reports 5110 cases of intussusception in infancy and childhood treated during the last 21 years. He makes a complete analysis on age, sex and seasonal frequency of 1597 cases met in the first six year period (1960 to 1965). Then, a statistic of 4 chief symptoms of 1000 consecutive cases under two years of age is given: abdominal pain 95,2%, vomiting 91,7%, bloody stool 83,3%, and sausage-shaped mass 73,6%. Among 5110 cases, only 512 were laparotomized, there were demonstrable organic causes in 22 cases. The method of reduction by colonic insufflation is described in detail step by step, with its indications, counterindications and possible complications. The author also presents his air insufflation apparatus with automatic control of the intracolonic pressure. Finally, he emphasizes the advantages of this method: of 4841 cases submitted to colonic insufflation, complete reduction was achieved in 4598, i.e. 94.98%, the rate of reduction is higher than that of barium enema. Thus, this method greatly decreased the need of operation, and consequently reduce the mortality and morbidity of the disease. Reduction of intussusception by colonic insufflations performed ambulatory and at a very low cost.