Meta-Analysis on Ultrasound Guided Hydrostatic Saline Enema Reduction of Childhood Intussusception

Abstract

Abstract Background Ultrasound with color Doppler studies plays a promising role in both the diagnosis as well as the guided reduction of intussusception by using hydrostatic pressure with normal saline enema as we can directly visualize the whole process of the reduction with real time ultrasound. Aim of the Work The study aims to assess the role and benefits of the ultrasound as an alternative non-invasive method in the guidance of the hydrostatic reduction of intussusception in children. Material and Methods A systematic review and meta-analysis on published studies about ultrasound guided hydrostatic saline enema reduction of childhood intussusception carried out in the period between 2010 and 2020. for pediatric patients suffering intussusception and was performed in accordance with the PRISMA and PICO guidelines. An initial search was carried out using online databases: PubMed/MEDLINE, Google Scholar, Egyptian Knowledge Bank and Science direct. The following search terms was employed: “(Intussusception AND hydrostatic OR saline enema AND ultrasound OR ultrasonography). Results A total of 133 articles were identified after duplicates were removed, and 102 were then excluded as they did not meet the inclusion criteria. The 31 remaining full-text articles were reviewed, and 10 were excluded due to (outside our time interval or containing insufficient data or other reasons of exclusion). Thus, 21 articles were included in the systematic review. Conclusion Hydrostatic reduction should be the treatment of choice and the first line of management in all cases of intussusception unless it is contraindicated. It is a simple, safe, effective and radiation free technique. It is not time consuming, is cost effective and is associated with almost nil complications and minimal hospital stay.