Variables determining the success of ultrasound-guided hydrostatic reduction of intussusception in infants

Abstract

Background: Intussusception represents one of the most common urgent surgical admissions during early infancy and childhood period. It’s a form of intestinal obstruction which is manifested by colicky abdominal pain, red current jelly stool and abdominal mass. Abdominal Ultrasound is the method of choice for diagnosis. Treatment of intussusception ranged from simple non operative reduction either by pneumatic or hydrostatic enema to surgical exploration. There multiple variables that may affect the result of of non operative management. Aim: We tried to study them to know whom patient would pass without surgery. Patients and methods: Two hundred patients diagnosed with intussusceptions included in this study. All of them received ultra sound guided hydrostatic reduction using warm saline. The maximum number of attempts of reduction was three times. We used intrvenous sedation in irritable infants. Results: 2 hundred cases with intussusception were treated in this study. One hundred forty were reduced (group A) and 60 cases (group B) required surgical exploration. The mean body weight in group A was 7.3 Kg while in group B 9.3Kg. seventy five cases from both groups were operated. Conclusion: Several factors affect the result of hydrostatic reduction as total leukocytic count, CRP and duration of symptoms. In addition the size of the mass and the presence or absence of free peritoneal fluid affects the non operative management. Keywords: hydrostatic, intussusception, ultrasound