Reduction Of Intussusception In Children Research Articles

Risk factors for failure of enema reduction of intussusception in children

Intussusception is a common surgical emergency in children. Clinical suspicion and radiological evaluation confirm the diagnosis of the disease. Enema reduction is the first line of management. This study aimed to explore the risk factors associated with enema reduction failure. A retrospective analysis of patients diagnosed with intussusception at three different hospitals in different countries from January 2016 to December 2022. Data collected included demographics, presenting symptoms, duration of symptoms, management, outcomes, and follow-ups. A total of 290 cases of intussusception were included in the study. Ages ranged from 1 to 36 months, with a median age of 15 months. All children underwent an enema reduction which was successful in 92.4%. Failure of reduction was seen in 16.7% of females compared to 6.4% of males, and it was significantly seen in children below the age of 1 year compared to older children. Failure of reduction significantly increases with the duration of symptoms and in children who present with bilious vomiting and currant jelly stool. In conclusion, Failure of enema reduction was more prevalent in females, in children below the age of 1 year and who present late, as well as children who had bilious vomiting and currant jelly stool. This study identified several risk factors associated with failed enema reduction in children with intussusception. Recognizing the risk factors can help guide clinicians in the management and anticipation of outcomes.

Role of Ultrasound Guided Pneumatic Reduction of Intussusception in Children Under 3 Years with Early Presentation

Background: Intussusception remains the most common cause of intestinal obstruction in children under 3 years of age. Objective: To evaluate the role of ultrasound guided pneumatic reduction of intussusception in children under 3 years with early presentation. Methods: This prospective interventional study was carried out at the Department of Pediatric Surgery in Dhaka Medical College Hospital, Dhaka from July, 2020 to June, 2022 for a period of 24 months. A total number of 22 patients with intussusception scheduled for Ultrasound Guided Pneumatic Reduction procedure to reduce intussusception were enrolled for this study after fulfilling the selection criteria. After Ultrasound Guided Pneumatic Reduction, patients were evaluated with duration of reduction, hospital stay and mass existence. Results: The mean age of the patients was 1.28 ± 0.83 years, ranging from 4 months to 3 years. Of them, 54.5% were below or equal to 1 year and the rest, 45.5% were above 1 year. All patients had abdominal pain and 86.4% palpable abdominal mass. Most of the mass situated at right hypochondrium (59.1%). The mean duration of reduction was 6.45 ± 1.29 minutes, ranging from 4 to 8 minutes. The mean duration of hospitalization was 15.90 ± 1.57 hours, ranging from 14 to 18 hours. In 9.1% of cases, the mass remained after the procedure. Conclusion: Intussusception can be effectively treated using pneumatic reduction, which is also quicker, less messy, and risk-free.

Comparison of Ultrasound Guided Saline Enema and X-ray-Guided Air Enema in the Treatment of Intussusception Reduction in Children.

To compare the effect of ultrasound guided saline enema (USGSE) and x-ray fluoroscopic air enema in the reduction of intussusception in children, 80 children with intussusception were randomly divided into ultrasonic-guided saline enema reduction in 40 cases (USGSE group) and x-ray air enema reduction in 40 cases (air enema group). The enema pressure, success rate, average time, and cost of the 2 methods were compared. The average operation time of the USGSE group was lower than that of the air group ([5.35 ± 1.79] min vs [6.03 ± 2.41] min, P = 0.159), the average pressure of the air group was higher than that of the air group ([10.95 ± 1.54] kPa vs [9.6 ± 1.26] kPa; P < 0.001), the success rate of resetting was higher than that of the air group (87.5% vs 85.0%; P = 0.745), and the cost of USGSE was lower than that of the air group ([339.23 ± 10.73] yuan vs [378.23 ± 18.20] yuan, P < 0.001). Subgroup analysis showed that the success rate of enema treatment in children with onset time <48 hours was significantly higher than that in children with onset time ≥48 hours (98.30% vs 54.50%, continuous correction χ 2 = 22.16; P < 0.001). The success rate and operation time of USGSE in pediatric intussusception reduction are similar to that of air enema, and the advantages of low cost and no radiation are worthy of popularization. For children with onset time ≥48 hours, enema reduction is safe and effective, but the conversion rate to open is high. It is necessary to carefully identify the symptoms of intestinal perforation and necrosis on the basis of strictly following the indications to avoid delayed treatment.

Predictors of Failure in Ultrasound-Guided Hydrostatic Reduction of Intussusception in Children: Retrospective Analysis in a Specialized Center in Ethiopia.

To identify factors predicting the failure of ultrasound-guided hydrostatic reduction of intussusception in children. The medical records of 174 children who underwent ultrasound-guided hydrostatic reduction of intussusception over four years were reviewed at Tikur Anbessa Specialized Hospital. Patient's demography, clinical data, and sonography findings (type of intussusception, length of intussusception, presence of lead point, trapped fluid, lymph node, and free peritoneal fluid) were entered into SPSS 25 (IBM) and analyzed using logistic regression. The overall success rate of ultrasound-guided hydrostatic reduction was 81.6%. The sex, presence of abdominal cramps, vomiting, diarrhea, trapped lymph nodes on ultrasound, or history of upper respiratory tract infection had no association with hydrostatic reducibility. Currant jelly stool (OR 0.128; 95% CI, 0.27-0.616; P=0.01), Ileo-ileo colic intussusception (OR 0.055; 95% CI, 0.005-0.597; P=0.017), pathologic lead point (OR 0.66; 95% CI, 0.01-0.447; P=0.005) and abdominal distention (OR 0.209; 95% CI, 0.044-0.998; P=0.048) showed significant association with failed hydrostatic reduction. The presence of currant jelly stool, ileo-ileo colic type intussusception, pathologic lead point, and abdominal distention are the most important predictors for failed ultrasound ultrasound-guided reduction intussusception in children.

Ultrasound-Guided Pneumatic Reduction of Intussusception in Children

Introduction: Intussusception, occurring most commonly in 6-month to 3-year-olds, involves bowel invagination with symptoms like abdominal pain, red currant jelly stool, and a palpable mass. The preferred treatment is non-operative, especially in stable cases without contraindications. Non-operative methods include ultrasound-guided hydrostatic and pneumatic reduction, as well as fluoroscopic-guided hydrostatic reduction with barium and pneumatic reduction with air enema. Methods: The prospective study took place at a specialized pediatric hospital over 36 months period. All children experiencing intussusception underwent abdominal sonographic assessment for diagnosis. Subsequently, an attempt was made to perform ultrasound-guided pneumatic reduction of the intussusception. Exclusions comprised hemodynamically unstable children, those displaying signs of peritonitis or bowel perforation, and those with sonographically identified pathological lead points. Results: A total of 98 children were treated with ultrasound-guided pneumatic reduction for intussusception.The average age of the patient was 11.38±9.24 months. Ileocolic intussusception was the most common finding in 98.9%. Around 80% of the patients was presented with complaints of severe abdominal pain. In 43.8% of the patients, the duration of symptoms was less than 24 hours. The mean length of intussusception was 3.64 cm. A total of 94 (96%) children had successful reduction of intussusceptions with recurrence found in only two of cases. Conclusion: Pneumatic reduction of intussusception is a highly effective procedure. It is associated with reduced morbidity and mortality and reduced risk of exploratory laparotomy. The main predictor for the outcome was the duration of symptoms before presentation to the institute, thus early use of pneumatic reduction is advisable.

Ultrasound-guided pneumatic reduction of intussusception in children: 15-year experience in a tertiary children's hospital.

International practice regarding the method used to nonoperatively reduce pediatric intussusception is variable. To provide an overview of ultrasound-guided pneumatic intussusception reduction and assess its safety and effectiveness. A single-center prospective study was conducted in a tertiary referral pediatric hospital during the 15-year period between January 2008 and February 2023. All patients with ileocolic intussusception underwent abdominal sonographic examination for diagnosis. An ultrasound-guided pneumatic reduction of intussusception was then attempted. Children who were hemodynamically unstable, with signs of peritonitis or bowel perforation and those with sonographically detected pathologic lead points were excluded. A total of 131 children (age range 2months to 6years) were enrolled in this study. Pneumatic intussusception reduction was successful in 128 patients (overall success rate 97.7%). In 117 patients, the intussusception was reduced on the first attempt and in the remaining on the second. In three cases, after three consecutive attempts, the intussusception was only partially reduced. As subsequently surgically proven, two of them were idiopathic and the third was secondary to an ileal polyp. No bowel perforation occurred during the reduction attempts. There was recurrence of intussusception in three patients within 24h after initial reduction which were again reduced by the same method. Ultrasound-guided pneumatic intussusception reduction is a well-tolerated, simple, safe and effective technique with a high success rate, no complications and no ionizing radiation exposure. It may be adopted as the first-line nonsurgical treatment of pediatric intussusception.

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

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.

A CLINICAL STUDY OF INTUSSUSCEPTION IN CHILDREN

A CLINICAL STUDY OF INTUSSUSCEPTION IN CHILDREN

Laparoscopic versus open reduction of idiopathic intussusception in children: an updated institutional experience

BackgroundIn the reduction of intussusception, due to the lack of randomized, controlled, and prospective clinical trials to confirm the superiority of the laparoscopic approach over open surgery, more evidence was needed. This study aimed to compare the results of laparoscopy and open reduction of idiopathic intussusception in children as well as to illustrate some skills for the reduction of intussusception laparoscopically.MethodsA retrospective review was performed to evaluate outcomes for patients with idiopathic intussusception who were treated laparoscopically (LAP group) from January 2015 to December 2019 and to compare the outcomes with laparotomy (OPEN group) during the same period.ResultsDuring the period studied, there were 162 patients treated surgically for intussusception: 62 LAP and 100 OPEN. No statistical differences were found in demographic data, clinical symptoms and signs, duration of symptoms, location and types of intussusception between the two groups. Conversion to open procedure was required for 11 patients in the LAP group. The operation time and time to oral intake were shorter in the LAP group while the difference was not significant. If the 11 conversion cases were excluded, the operation time and time to oral intake were significantly shorter (P < 0.05) in the LAP group. The length of stay was significantly shorter in the LAP group (P < 0.05). Intraoperative and postoperative complication rates between the two groups were comparable (P = 1.0).ConclusionLaparoscopy was safe and effective in the treatment of pediatric idiopathic intussusceptions. Pediatric surgeons with sophisticated minimally invasive skills should choose laparoscopy as the first choice in the treatment of idiopathic intussusceptions.

Outcome of ultrasound guided reduction of intussusception in children by saline enema

Background: Intussuception is a common cause of acute intestinal obstruction in children and contributor of morbidity and mortality in children. The purpose of this study was to evaluate efficacy of hydrostatic reduction of intussusception over operative reduction using normal saline enema in children and to identify procedure related complications.Methods: All patients presenting to us with features of intussusception clinically and confirmed by ultrasonography between June 2015 to November 2017 were included in study. Depending on haemodynamic stability of patient and surgeon’s preference, patients were subjected to trial of hydrostatic reduction by normal saline enema or operative procedure. Patients with failure or partial reduction were taken for surgery.Results: The mean age was 21.07 months with a male preponderance. Of 53 patients attending the institute, 32 were given a trial of hydrostatic reduction which was successful in 28. Thus success rate was 87.5%. 1 patient succumbed resulting in 1.4% mortality rate after the procedure. It was observed that longer duration of symptoms reduced chances of reduction. 88%patients with successful hydrostatic reduction were discharged within 4 days of admission.Conclusions: We conclude that ultrasound guided saline enema is simple ,safe and effective method of treating intussusception in children with low rate of complications and can be strongly recommended as first line of treatment of intussusception in select group of paediatric patient, especially those reporting early to the hospital.

Ultrasound-guided hydrostatic enema reduction of intussusception and confirmation with single abdominal radiograph in children.

To detect false-positive reduction results after ultrasound (US)-guided hydrostatic intussusception reduction, we have incorporated water-soluble contrast material to the enema fluid and confirmed the reduction with a single abdominal radiograph. We present the results of the combined imaging method for the reduction of intussusception in children. The records of the patients who were treated for intussusception were analyzed retrospectively. Patients were divided into two groups: a US-guided reduction group and a US-guided reduction plus radiographic control group. The patient characteristics, symptoms, treatment methods, outcomes, and complications and follow-up were analyzed. A total of 164 intussusception episodes were treated in 153 patients. Hydrostatic reduction of intussusception was performed in 59 patients in the US-guided group and in 94 patients in the US-guided plus radiographic control group. Recurrence rate in the US-guided group was 15.7%, vs 3.5% in the US-guided plus radiography group (P = .029). In the US-guided plus radiographic control group, 5 (5.3%) false positive reductions under US guidance were determined by abdominal radiography. In order to decrease false positive reduction rate and early recurrence, US-guided intussusception reduction can be performed with saline plus water-soluble contrast material and confirmation of reduction obtained with a single direct abdominal radiograph.

Intussusception in children: effect of symptom duration on the outcome of hydrostatic reduction

BackgroundIntussusception is a common cause of intestinal obstruction in children, especially in infants. Intussusception is a pediatric abdominal surgical emergency, and hydrostatic reduction is an effective modality of treatment in selected group of patients. There are lack of data in Nigeria on the effect of symptom duration on hydrostatic reduction.AimTo evaluate the effect of duration of symptoms on the outcome of hydrostatic reduction of intussusception.Patients and methodsThis was a prospective study on the effect of symptom duration on the success of hydrostatic reduction of intussusception in children. This study was carried out at the pediatric surgery unit of a teaching hospital over a 3-year period. The patients were categorized into two groups: group A included patients who had successful reduction, and group B included patients who had unsuccessful (failed) reduction.ResultsA total of 96 cases of intussusception were managed during the study period, of which 32 (33.3%) patients underwent hydrostatic reduction. Mean age of the patients was 7 months, with a range of 4–12 months. Male to female ratio was 1.9: 1. All the patients had abdominal pain. There was more successful hydrostatic reduction in patients who presented within 48 h of onset of symptoms (group A), and this was statistically significant (P = 0.04).ConclusionChildren with intussusception who present early (within 48 h of onset of symptoms) had more successful hydrostatic reduction when compared with patients who present after 48 h.

Factors associated with a failed nonoperative reduction of intussusception in children

Aims:The aim of this study was to evaluate the factors associated with the failure of nonoperative reduction of intussusception in children.Methods:A retrospective study was conducted in a tertiary care pediatric surgery hospital. The children admitted to the department of pediatric surgery between November 2013 and February 2020 with the diagnosis of Intussusception were included.Results:A total of 106 (67%) children underwent pneumatic reduction. Eighty-nine (84%) children had a successful reduction. A higher rate of failed reduction was found in children who presented at or after 48 h of the onset of symptoms (P = 0.03) and abdominal distension at presentation (P < 0.002). On multiple logistic regression analysis, the children presenting at or after 48 h of the onset of symptoms (odds ratio [OR] = 11.3; P = 0.039) and abdominal distension at presentation (OR = 4.46; P = 0.021) were found to be associated with increased risk of failure of nonoperative reduction. The variables age <1 year, weight <10 kg, pain abdomen, vomiting, bilious vomiting, fever, bleeding per rectum, and palpable mass were not associated with the failed nonoperative reduction. The variables, presentation at or after 48 h of the onset of symptoms (OR = 2.812; P = 0.045) and abdominal distension at presentation (OR = 8.758; P = 0.000) were found to be associated with an increased need for surgery.Conclusion:The risk factors for failed nonoperative reduction of intussusception include a presentation at or after 48 h of the onset of symptoms and the presence of abdominal distension at presentation. The delayed presentation was associated with the increased need for surgery and increased chances of intestinal nonviability.

Effectiveness of ultrasound-guided hydrostatic reduction of intussusception in children

Aim: To review the effectiveness of ultrasound- guided hydrostatic reduction of intussusception in children.&#x0D; Methods: This prospective interventional study was done during one year period from January 2014 to December 2014 in the department of Radiology and Imaging of Dhaka Medical College and Hospital, Dhaka and included 30 children clinically and radiologically diagnosed as intussusception with symptoms d” 48 hours. They underwent ultrasound-guided hydrostatic reduction using normal saline and the effectiveness of this technique was reviewed.&#x0D; Results: Majority of the study population were in the age group of 7-24 months with mean age of 9.04± 2.48 months. 100% patients who presented within 24 hours of their symptoms achieved successful reduction whereas success rate of reduction were 95% and 0% respectively in patients presented within 24-36 hours and after 36 hours of their symptoms. 60% cases required 5-10 minutes for successful reduction, 20% cases required 3-5 minutes and 10% patients needed &gt; 10 minutes. Within 3 attempts, reduction happened in 90% cases whereas 10% cases failed to reduce. No case was tried for reduction after 3 attempts in consideration of the bowel pathology and complications. Only 10% patients developed negligible complications. No case showed recurrence.&#x0D; Conclusion: Ultrasound guided hydrostatic reduction of intussusception is an effective nonoperative treatment of intussusception in children because of its high success rate, less complications and recurrence rate.&#x0D; J Dhaka Medical College, Vol. 27, No.2, October, 2018, Page 134-140

Hydrostatic reduction of intussusception in children: a single centre experience.

Introductionintussusception is a common surgical emergency in children especially in infants. Treatment of intussusception could be non-operative or operative. Non-operative treatment (hydrostatic reduction) of intussusception is increasingly being practiced in developing countries.Methodsthis was a review of our experience in the hydrostatic reduction of intussusception in children at a teaching hospital in Enugu, Nigeria. This study covered an 18-months period, October 2017 to March 2019. Patients on presentation were resuscitated, appropriate investigations done and prepared for surgery before the hydrostatic reduction (using normal saline) was carried out. Patients with features of peritonitis and marked abdominal distension were excluded from hydrostatic reduction.Resultstwenty patients who had 21 episodes of intussusception were analyzed. One patient had a recurrence that necessitated repeat hydrostatic reduction. Eighty percent of the patients were male. The mean and peak age of the patients was 8 months and 6 months respectively. Significant number of the patients presented after 48 hours of onset of their symptoms. Abdominal pain was the predominant presenting symptom. Twenty percent and fifteen percent of the patients had a history of preceding gastrointestinal and respiratory infections preceding the intussusception respectively. Ileocolic intussusception was the most common type and the most distal end of the intussusception was at the transverse colon. Hydrostatic reduction was successful in 13 patients (65%).Conclusionhydrostatic reduction is a simple and effective method of treatment of intussusception. However, early presentation and proper patient selection is necessary for optimal outcome.

Sonographic guided hydrostatic saline enema reduction of childhood intussusception: a prospective study

BackgroundThe management of childhood intussusception in our sub-region is still via surgical intervention. Currently, the gold standard of treatment is non-operative reduction. We sought to assess the suitability of hydrostatic (saline) reduction of intussusception in children in our institution.Materials and methodsA prospective study was conducted between January 2016 and June 2017 in all children with ultrasound confirmed intussusception at a tertiary teaching hospital in Nigeria. All children excluding those with signs of peritonitis, bowel gangrene and intestinal prolapse were selected for ultrasound-guided hydrostatic reduction (USGHR). We allowed a maximum of three attempts at reduction.ResultsThe age range was 3 months to 48 months with a mean of 10.8 ± 9.1 months. Forty percent (N = 18) presented after 24 h of onset of symptoms. The success rate of hydrostatic reduction with saline enema was 84.4% (N = 38). Two (4.4%) perforations occurred during the procedure. Three (7.5%) patients had recurrent intussusception within six months. The duration of symptoms greater than 24 h, age and sex of patients did not influence successful reduction p > 0.05. The duration of admission between those who had successful non-operative reduction and those who subsequently had operative reduction and or resection attained statistical significant difference, p = 0.001. There was no mortality. We achieved a 68% decrease in the operative reduction of intussusception using USGHR as the primary modality of treatment.ConclusionOur study found out that USGHR is a suitable alternative for the treatment of childhood intussusception.

Pneumatic reduction of intussusception in children

Context and Aims: Pneumatic reduction has a higher success rate and lower incidence of complications compared to barium enema and hydrostatic reductions. What is deterrent to its common use is the cumbersome technique. Our technique is simple that can be used in any hospital with locally available facilities. Settings and Design: This was a prospective study. Subjects and Methods: A total of 25 children were enrolled in the study between September 2015 and June 2016 at our institute. Patients were given air enema under US guidance using locally assembled equipment. The intraluminal pressure was monitored with a pressure gauge and was not permitted to go above 100 mmHg. A total of three attempts of 3 min each were allowed. Statistical Analysis Used: We just used simple statistic to calculate average. Results: There were 17 males and 8 females. The average age of the patients was 8.5 months. Twenty-two (88%) of the cases were reduced successfully while 3 (12%) failed to reduce. A majority of those that did not reduced had symptoms for at least 4 days. No bowel perforation occurred in our study. All cases of the intussusception have length Conclusions: The technique described is easy to assemble, safe, and effective. We recommend it for regular use in pneumatic reduction of intussusception, especially in the center have limited resources.

Clinical prediction rules for failed nonoperative reduction of intussusception.

PurposeThe nonoperative reduction of intussusception in children can be performed safely if there are no contraindications. Many risk factors associated with failed reduction were defined. The aim of this study was to develop a scoring system for predicting the failure of nonoperative reduction using various determinants.Patients and methodsThe data were collected from Chiang Mai University Hospital and Siriraj Hospital from January 2006 to December 2012. Inclusion criteria consisted of patients with intussusception aged 0–15 years with no contraindications for nonoperative reduction. The clinical prediction rules were developed using significant risk factors from the multivariable analysis.ResultsA total of 170 patients with intussusception were included in the study. In the final analysis model, 154 patients were used for identifying the significant risk factors of failure of reduction. Ten factors clustering by the age of 3 years were identified and used for developing the clinical prediction rules, and the factors were as follows: body weight <12 kg (relative risk [RR] =1.48, P=0.004), duration of symptoms >48 hours (RR =1.26, P<0.001), vomiting (RR =1.63, P<0.001), rectal bleeding (RR =1.50, P<0.001), abdominal distension (RR =1.60, P=0.003), temperature >37.8°C (RR =1.51, P<0.001), palpable mass (RR =1.26, P<0.001), location of mass (left over right side RR =1.48, P<0.001), ultrasound showed poor prognostic signs (RR =1.35, P<0.001), and the method of reduction (hydrostatic over pneumatic, RR =1.34, P=0.023). Prediction scores ranged from 0 to 16. A high-risk group (scores 12–16) predicted a greater chance of reduction failure (likelihood ratio of positive [LR+] =18.22, P<0.001). A low-risk group (score 0–11) predicted a lower chance of reduction failure (LR+ =0.79, P<0.001). The performance of the scoring model was 80.68% (area under the receiver operating characteristic curve).ConclusionThis scoring guideline was used to predict the results of nonoperative reduction and forecast the prognosis of the failed reduction. The usefulness of these prediction scores is for informing the parents before the reduction. This scoring system can be used as a guide to promote the possible referral of the cases to tertiary centers with facilities for nonoperative reduction if possible.

Surgical outcomes after failed air enema reduction of intussusception in children in a paediatric hospital in Singapore

Purpose: The aim of this study is to determine the surgical outcomes after failed air enema reduction of intussusception in children in a paediatric hospital in Singapore. Knowledge of the surgical findings in cases of failed reductions may potentially help clinicians determine which cases need further investigation should there be a secondary cause of the intussusception such as a pathological lead point.

Role of Ultrasound-Guided Hydrostatic Reduction of Intussusception in Children with Early Presentation

General objective: To study the efficacy of Ultrasoundguided hydrostatic reduction of intussusception in children with early presentation.Methods: The study group included children aged 03 months to 02 years with early case of intussusception confirmed on ultrasonography. One litre of normal saline bag was suspended at 100 cm height from the patient’s level. After connecting the saline bag with Foley’s catheter introduced in the rectum, gradual distension of colon and retrograde movement of intussusceptum towards the caecum monitored by real time ultrasound.Successful reduction was assumed once mass was disappeared and passage of saline into the small intestine. If 1st attempt failed but there is some movement of the mass was present and child had no abdominal signs, 2nd and 3rd attempts were taken at least 30 min interval.Result: The overall success rate of US-guided hydrostatic reduction of intussusception in children with early presentation was about 90%, with no immediate recurrence and no perforation.Conclusion: Ultrasound guided hydrostatic reduction should be the first line of the treatment in patients with early presentation of intussusceptions aged between 3 months and 2 years old. In cases with failed initial reduction, a second or even third attempt may provide successful reduction.J. Paediatr. Surg. Bangladesh 3(2): 61-64, 2012 (July)