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Hydrostatic reduction of acute intussusception. A prospective study
1Department of Surgery, Radiology, Anaesthesia and Intensive Care, University of the West Indies, Mona, Jamaica.
Insights
Hydrostatic reduction successfully treated 54% of acute intussusception episodes in Jamaican children. This method is recommended as the first therapeutic option for intussusception, avoiding major surgery.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Intussusception is a common surgical emergency in infants and children.
- Prompt diagnosis and treatment are crucial to reduce morbidity and mortality.
Purpose of the Study:
- To evaluate the efficacy and safety of hydrostatic reduction for acute intussusception in Jamaican children.
- To compare hydrostatic reduction with operative methods.
Main Methods:
- Prospective data collection on 62 episodes of acute intussusception in 57 children over two years.
- Application of operative and hydrostatic reduction techniques (barium, saline, air).
Main Results:
- Successful hydrostatic reduction was achieved in 31 (54%) of episodes.
- Common types included ileo-colic, caeco-colic, ileo-ileo-colic, and ileo-ileal intussusception.
- Two cases of barium hydrostatic perforation occurred, with one fatality.
Conclusions:
- Hydrostatic reduction is a safe and effective first-line treatment for acute intussusception.
- Successful hydrostatic reduction avoids the need for major operative procedures.
- Careful consideration of hydrostatic agents is necessary due to potential complications.
Abstract:
Data were collected prospectively on 57 Jamaican children presenting with 62 episodes of acute intussusception over a two year period, for whom operative and hydrostatic methods of reduction were employed. 31 (54%) of 57 episodes were reduced successfully using barium (42), saline (11) and air (4) hydrostatically. Among the 31 other episodes, 15 had ileo-colic intussusception, seven caeco-colic, six ileo-ileo-colic and one ileo-ileal. Two patients had spontaneous reduction discovered at surgery. There were two episodes of barium hydrostatic perforation of the colon leading to death in one patient. Hydrostatic reduction is recommended as the first therapeutic option for acute intussusception because it spares the patient a major operative procedure when successful.
