Type Of Intussusception Research Articles

Adult intussusception: a systematic review of current literature.

Intussusception in adults is a rare condition characterized by a low incidence, which complicates the establishment of standardized management protocols unlike those readily available for pediatric cases. This study presents a case series from our institution alongside a systematic review of existing literature. The objective is to delineate effective management strategies for adult intussusception. A systematic search of databases was conducted covering the period from January 2000 to May 2024. The study focused on adult patients diagnosed with intussusception either pre-operatively or intraoperatively and managed with either surgical intervention or conservative methods. The analysis also included retrospective review of patient records from our institution, specifically targeting individuals over 18years of age, to determine the predominant types of intussusception and identify any pathological lead points associated with these cases. In our study, a total of 1,902 patients were included from 59 selected articles, with a mean age of 52.13 ± 14.95years. Among them, 1,920 intussusceptions were diagnosed, with 98.3% of cases identified preoperatively. Computed tomography (CT) scan was the primary diagnostic modality used in 88.5% of cases. Abdominal pain was the predominant presenting symptom, observed in 86.23% of cases. Only 29 out of 1,920 cases underwent attempted reduction, while the majority required surgical resection due to the high incidence of malignancy in adult cases. The most common type of intussusception identified was colocolic (16.82%), followed by enteric (13.28%), ileocolic (4.89%), and ileocaecal (0.78%) types. A pathological lead point was observed in 302 out of 673 patients (44.84%), with a notably higher frequency of malignancy associated with colocolic intussusception. Surgical management remains the cornerstone in treating adult intussusception, particularly in cases involving the colocolic type, where there is a significant risk of underlying malignancy. Attempts at reduction are generally avoided due to the potential risk of tumor dissemination, which could adversely impact patient outcomes. Contrast-enhanced computed tomography (CECT) of the abdomen is pivotal for accurately diagnosing intussusceptions and guiding appropriate management strategies. It is imperative to adhere strictly to oncological principles during surgical interventions to ensure optimal patient care and outcomes.

Хірургічні ускладнення пурпури Шенляйн-Геноха в дітей

Henoch-Schönlein purpura is the systemic pathology that affected the small vessels of the skin, gastrointestinal tract, kidneys, and joints. Typical clinical manifestation of Henoch-Schönlein purpura include palpable purpura, abdominal pain syndrome, arthralgia, renal involvement, and, in some children, externa genitalia involvement. The aim of this study was to present the own experience in the management of three children with the surgical complications of Henoch-Schönlein purpura. The own experience includes three children with Henoch-Schönlein purpura, particularly two children with ileum intussusception (both of 3 years old) and one patient of 4 years old with the syndrome “acute scrotum”. Gastrointestinal involvement may appear in most of patients with Henoch-Schönlein purpura and intussusception is the most common complication, which require the urgent treatment. Appearance of typical palpable purpura followed the abdominal pain syndrome and ultrasonography is the main method of diagnostic in this group of patients. Ileum and ileocolic are the common types of intussusception in children with Henoch-Schönlein purpura. The main method of treatment in case of ileum intussusception is surgical reduction, while in case of ileocolic intussusception non-surgical reduction can be applied. Besides the typical manifestation of Henoch-Schönlein purpura, in some children could be the scrotal involvement, which developing after appearance of palpable purpura, and rare caused by inflammation or torsion of testis or hydatid. It is believed that patients with Henoch-Schönlein purpura and scrotal involvement have more severe clinical course when compared with patients with abdominal manifestation, which agreed with our observation. Conclusions. In children older than one year, with the abdominal pain, with or without bloody stools, and ultrasonographic signs of intussusception, it is necessary consider about possibility the presence of Henoch-Schönlein purpura in these patients. In children with Henoch-Schönlein purpura despite the corticosteroids’ treatment, could be developed the syndrome of “acute scrotum”, which required emergent surgery. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the patients was obtained for the research. No conflict of interests was declared by the authors.

IJCM_41A: Epidemiology of intussusception hospitalization and its potential risk with Rotasiil among vaccinated children admitted in a tertiary care hospital in South India

Background: There is an established well reported link of intussusception with the use of rotavirus vaccines. Little is known about the newly introduced rotasiil vaccine causing intussusception. So, this study has been undertaken to study the epidemiology of intussusception and its potential risk among children vaccinated with Rotasiil vaccine. Methodology: A hospital based cross-sectional study was conducted for a period of 2 years among children <2 years admitted with confirmed intussusception. A predesigned semi structured questionnaire was used to capture sociodemographic data by interviewing parents and clinical data was collected from hospital records. Vaccination details was extracted from vaccination cards. Data was expressed in percentages and proportions. Results: Out of 80 confirmed cases of intussusception 64 (80%) children received rotasiil vaccine. The mean age of the study participants was 12+ 6 months and 67.5% of them were males. Out of the vaccinated children 82.8% and 98.4% of them had received all the doses and only two doses respectively. The median age (IQR) of receiving first, second and third doses was 7.6 (6.9-9.4), 12.9 (11.9-15.4), and 17.9 (16.4-21.8) weeks, respectively. Among them 95.3% of participants had ileocolic type of intussusception and 89% of it was resolved by non-surgical procedures. Within a risk period of 1-21 days postvaccination 1 and 8 cases of intussusception were reported after second and third dose respectively Conclusion: There were more number of cases of intussusception observed in the high risk period of 1-21 days after the third dose as compared to that of first and second dose of rotasiil vaccine

Clinical presentation and management outcome of pediatric intussusception at Wolaita Sodo University Comprehensive Specialized Hospital: a retrospective cross-sectional study.

To assess the pattern of clinical presentations and factors associated with the management outcome of pediatric intussusception among children treated at Wolaita Sodo University Comprehensive Specialized Hospital, Ethiopia. This retrospective cross-sectional study included the medical records of 103 children treated for intussusception from 2018 to 2020. The data collected were analyzed using SPSS 25.0 (IBM Corp., Armonk, NY, USA). In total, 84 (81.6%) patients were released with a favorable outcome. Ileocolic intussusception was a positive predictor, with a nine-fold higher likelihood of a favorable outcome than other types of intussusception [adjusted odds ratio (AOR), 9.16; 95% confidence interval (CI), 2.39-21.2]. Additionally, a favorable outcome was three times more likely in patients who did than did not undergo manual reduction (AOR, 3.08; 95% CI, 3.05-5.48). Patients aged <1 year were 96% less likely to have a positive outcome than those aged >4 years (AOR, 0.04; 95% CI, 0.03-0.57). Most patients were discharged with favorable outcomes. Having ileocolic intussusception and undergoing manual reduction were associated with significantly more favorable outcomes of pediatric intussusception. Therefore, nonsurgical management such as hydrostatic enema and pneumatic reduction is recommended to reduce hospital discharge of patients with unfavorable outcomes.

Clinical Presentations, MDCT Features, and Treatment of Three Types of Adult Intussusceptions Based on the Location.

This study aimed to explore the similarities and differences in clinical presentations, multidetector computed tomographic (MDCT) features, and treatment of three types of adult intussusceptions based on location. We retrospectively reviewed 184 adult patients with 192 intussusceptions. Depending on the location, intussusceptions were classified as enteric, ileocolic, and colonic types. The similarities and differences of clinical presentations, MDCT features, and treatment of three types of adult intussusception were compared. Meanwhile, the three types of intussusceptions were further divided into surgical and conservative groups based on the treatment. Uni- and multivariate logistic analyses were used to identify risk factors for intussusception requiring surgery. Enteric and ileocolic intussusceptions were mainly presented with abdominal pain (78.46% and 85.71%). Hematochezia/melena (64.29%) was the main symptom of colonic intussusception. On MDCT, ileocolic intussusceptions were longer in length and had more signs of intestinal necrosis (hypodense layer, fluid collection and no/poor bowel wall enhancement) than enteric and colonic intussusceptions. Moreover, it was found that 93.88% (46/49) of ileocolic intussusception and 98.59% (70/71) of colonic intussusception belonged to the surgical group, whereas only 43.06% (31/72) of enteric intussusception belonged to the surgical group. Intussusception length (OR=1.171, P=0.028) and discernible lead point on MDCT (OR=21.003, P<0.001) were reliable indicators of enteric intussusception requiring surgery. Ileocolic intussusception may be more prone to intestinal necrosis than enteric and colonic intussusceptions, requiring more attention from clinicians. Surgery remains the treatment of choice for most ileocolic and colonic intussusceptions. Less than half of enteric intussusceptions require surgery, and MDCT features are effective in identifying them.

A CLINICAL STUDY OF INTUSSUSCEPTION IN CHILDREN

A CLINICAL STUDY OF INTUSSUSCEPTION IN CHILDREN

Gastro gastric intussusception in the setting of unclear lead point Radiological imaging

Intussusception is defined as telescoping or invagination of the proximal part of the gastrointestinal tract (intussusceptum) into an adjacent section (intussuscipiens) which results in obliteration of the lumen [1-2]. It is considered as a form of bowel obstruction as it accounts for only 1-5% of cases of bowel obstruction [3]. Intussusception in children can occur at any site in the GI tract, and it often presents similar clinical and radiographic features at all sites. These characteristic features are the key to diagnose intussusception even at unusual sites [4]. While Intussusception is a common diagnosis among children, it is in fact a rare condition in adults with the incidence of approximately 2-3 per 1,000,000 per year [5-6]. Adult intussusception is usually presented with vaguely unusual symptoms where the use of EUS and CT is extremely useful to aid in diagnosis [1-7]. Our case presents an even rarer type of Intussusception called Gastro-gastric Intussusception. According to multiple sources it consists of only 10% of the adult Intussusceptions [7-8].

Transient intussusception without a lead point in adults — a rare condition or a silent cause of common symptoms?

Bowel intussusception is a rare condition in adults. Two types of intussusception determine its cause — with and without a lead point. The former, resulting from an organic cause is more common in adults and usually requires surgical treatment. The symptoms of intussusception include abdominal pain, nausea, vomiting and gastrointestinal obstruction. Additional symptoms may be due to the presence of the pathology that constitutes the lead point of intussusception, such as a tumour or inflammatory intestinal disease. On diagnostic imaging, intussusception appears as a target-sign or sausage-shaped mass. Due to the rare occurrence of intussusception in adults, special attention should be paid to detecting the underlying organic causes of its occurrence. Transient intussusception is generally a non-lead point, occurs incidentally and is not life-threatening. Non-diagnosed periodic abdominal pains in adults can be caused by a transient intussusception of the small bowel. The article presents and discusses two cases of a rare transient non-lead point intussusception that was diagnosed during a CT which subsided or occurred during the consecutive phases of this examination.

Intussusception in Five Months Old Infant, A Rare Cause Colocolica without Pathologic Lead Point: A Case Report

Intussusception is a common cause in gastrointestinal obstruction and one of condition in which early treatment is critical. Given the risk of acute bowel ischemia, intussusception represents an abdominal emergency in the pediatric population. The symptoms are generally related to intestinal obstruction, as intussusception accounts for up to 50% of pediatric small bowel obstructions in some series. Colocolica intussusception is an uncommon type of intussusception in children that is usually associated with a pathological lead point. This report depicts a five-months-old female baby with a chief complaint of bloody stool 7 hours before admission, accompanied with non-bilious vomit. Patient exhibited the classic triad of intussusception and upon the radiologic examination, a colocolica was noted. Patient then underwent urgent exploratory laparotomy, and the colocolica was reduced through manual reduction (milking technique).

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.

Point-of-Care Ultrasound For Differentiating Ileocolic From Small Bowel-Small Bowel Intussusception.

Intussusception is a common pediatric emergency. The two types of intussusception are ileocolic intussusception (ICI) and small bowel-small bowel intussusception (SB-SBI), and neither are easily distinguished clinically. ICI requires radiology personnel and potentially surgical assistance for its reduction. SB-SBI is managed expectantly, as many resolve spontaneously. Differentiating between ICI and SB-SBI through point-of-care ultrasound (POCUS) requires an understanding of their salient features. Identification of the correct type of intussusception immediately assists decision making and patient disposition. Our objective was to provide guidance on POCUS technique for intussusception identification, and to review the ultrasound literature differentiating ICI from SB-SBI. We systematically searched 3 separate databases and gray literature to identify articles that met our criteria and assessed them for final review. The final articles were graded for quality using The National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies. A total of 858 articles were identified. Six articles were included in the final review. All studies were conducted in pediatric patients in different countries. Most were found to have a fair quality of evidence. The linear transducer is used when evaluating intussusception. Both ICI and SB-SBI are identified easily on POCUS, but they differ sonographically with respect to region within the abdomen, intussusception parameters, lymph nodes, and other salient features seen on real-time video. ICI and SB-SBI can be identified and differentiated using several sonographic features. POCUS is capable of expeditiously aiding the emergency physician's decision making and disposition when managing intussusception.

Intussusception in Children: A Prospective Cohort Study

Introduction: Intussusception is one of the most frequent causes of bowel obstruction in infants and toddlers. Due to wide variety of clinical presentations and overlap with other abdominal conditions, the diagnosis of intussusception is often delayed. Delayed diagnosis and treatment leading to gangrene and perforation of the bowel increases the morbidity and mortality of this condition. Therefore, prompt diagnosis and treatment is warranted for better outcome. Aim: To find out the possible aetiological factors, clinical presentation and treatment outcome of intussusception in children. Materials and Methods: A prospective descriptive cohort study was conducted in the Department of General Surgery from October 2018 to November 2020, in which 30 patients with diagnosis of intussusception undergoing either hydrostatic reduction or open surgical intervention were enrolled. Age and sex were the independent variables while surgical outcome was the dependent variable assessed. Results: Thirty patients (males=17 and females=13) of intussusception who had met the inclusion criteria were included in the study. Mean age of the patients were 10.8±19.12 months. In 83.33% patients, intussusception was idiopathic, while, pathological lead point was noted in 16.7% patients. Ileo- colic (76.67%) was the most common type of intussusception detected. A 70% patient’s required open surgery while hydrostatic reduction carried out in 30% patients. No mortality was observed in this study. Conclusion: The commonly affected age group was 7 to 12 months. Surgery is the mainstay of treatment while hydrostatic reduction is effective in few properly selected patients.

The syringe technique for ultrasound-guided hydrostatic intussusception reduction

ABSTRACTBackground:Ultrasound-guided hydrostatic reduction (UGHR) is a well accepted and widely used method of paediatric intussusception reduction, with the saline drip technique being the most commonly employed.Aims and Objectives:In this study we aimed to assess the outcomes of a novel technique of UGHR.Materials and Methods:Data was obtained from a 15 year retrospective chart review of paediatric intussusceptions. Following resuscitation, UGHR was performed for uncomplicated intussusceptions using a 50cc syringe to infuse saline into the colon. It was performed in the ultrasound suite without sedation and time taken was monitored. A maximum of 3 attempts were done to achieve reduction.Results:UGHR was attempted in 66 of 93 intussusceptions. The commonest type of intussusception was ileo-colic(91%) and the commonest symptom was vomiting(70%). Surgery was performed only when there was shock, peritonitis or repeated failed reductions. The median time taken for reduction was 4.9 minutes. The overall success rate was 83% with 89% of these requiring only a single attempt. There were no deaths or procedure related complications.Conclusions:The syringe technique for intussusception reduction is a safe, effective, and time-saving technique. Additionally, it offers the advantages of simplicity and rapidity of reduction and in experienced hands may not require pressure monitoring

The diagnosis and treatment of retrograde intussusception: a single-centre experience

Background/PurposeTo investigate the clinical manifestations, treatments of retrograde intussusception and summarize the experience.MethodsChildren with retrograde intussusception treated in our hospital from January 2011 to January 2021 were retrospectively analysed. Demographics, clinical manifestations, preoperative colour Doppler ultrasound (CDU) findings, findings during surgery and follow-up results were collected.ResultsA total of 4719 cases of intussusception were treated in our department, including 12 cases of retrograde intussusception (0.25%). There were 8 males and 4 females.The age ranged from 4.1 to 14.3 months, with an average of (8.3 ± 2.8) months.; The weight ranged from 5.5 to 12.6 kg, with an average of (9.4 ± 2.3) kg; The onset time ranged from 6 to 15 h, with an average of (10.0 ± 2.4) h. All the children received CDU examination before surgery, and in one case, the possibility of 2 intussusception masses was considered. Emergency surgical exploration was performed after the failure of air enema reduction. During the operation, multiple types of intussusception were found (coincidence of anterograde and retrograde intussusception). The pattern of anterograde intussusception was all ileo-ileo-colic variety and the retrograde intussusception was proximal sigmoid colon into descending colon. All the children were successfully reduced by manual reduction without intestinal necrosis or intestinal malformation. All children were discharged 6–7 days after surgery, and had no recurrence after 3–6 months of follow-up.ConclusionsRetrograde intussusception is easily misdiagnosed before surgery. During air enema, if the intussusception mass was fixed and did not move with increasing pressure, we should be aware of the possibility of retrograde intussusception, and the enema pressure should not be too large to avoid intestinal perforation. If the intraoperative position of the intussusception mass was not consistent with that of the preoperative enema, it was recommended to use bimanual examination to explore whether there was still a mass in the abdominal cavity to avoid misdiagnosis.

Nonsurgical reduction of prolapsed colocolic intussusception in 2 puppies.

To describe the nonsurgical management of prolapsed colocolic intussusception in 2 puppies. Two 3-month-old male intact puppies (Pug and Labrador Retriever) developed intussusceptions that had prolapsed from the anus after they had suffered from tenesmus with soft feces or diarrhea. Reduction of the prolapsed tissue was performed and colocolic intussusception was diagnosed ultrasonographically in 1 dog. Rectal manipulation and saline enema were performed in both dogs, and reduction of the intussusception was confirmed endoscopically or ultrasonographically. Bupivacaine and prednisolone foam enemas were administered to reduce tenesmus. Abdominal ultrasonography the following day in 1 dog confirmed a normal appearing colon. No further tenesmus was noted in 1 dog; the other had a brief rectal prolapse after an episode of tenesmus that was manually reduced. Intussusception had not recurred 4 months and 1 year following manual reduction procedures. This is the first report of successful nonsurgical management of colocolic intussusception in a companion animal. Nonsurgical management is a first-line treatment of intussusception in children and could be considered in dogs with colocolic intussusception. Further investigation is required to define specific aspects, including rectal manipulation, saline enema, or anesthesia, that aid in resolution of this type of intussusception.

OUTCOME OF ULTRASOUND GUIDED REDUCTION OF INTUSSUSCEPTION USING NORMAL SALINE: EXPERIENCE OF A TERTIARY CARE HOSPITAL OF PESHAWAR, PAKISTAN

OBJECTIVE: To determine the success rate of ultrasound guided hydrostatic reduction of intussusception using normal saline as an alternative to laparotomy. METHODS: This prospective cross-sectional study was conducted at Pediatric Surgery department, Khyber Teaching Hospital, Peshawar from January-September 2018. Eighty patients aged between 3-24 months with clinical signs, symptoms and confirmatory sonographic evidence of intussusception were included in study. Procedure was carried out under ultrasound guidance using normal saline as medium for reduction. Maximum, three attempts were made each lasting 5-10 minutes. &nbsp; RESULTS: Mean age of patients was 11.9±4.8 months. Majority (n=60/80; 75%) of patients were males. Thirty-five percent of patients (n=28/80) presented on second day followed by 32.5% (n=26/80) on first day. Mean time for presentation was 2.1±0.9 days. Most common type of intussusception was Ileo-colic (n=72/80; 90%). Overall success rate was 82.5% (n=66/88). &nbsp;Success rate for patients presented within first day was 96.2% (n=25/26) as compared to 85.7% (n=24/28) in patients presented ≥1-2 days and 65.3% (17/26) in patients presented after two days. Reduction time of Intussusception ranged from 5-30 minutes with mean time of 17.5±1.4 minutes. In 76.3% (n=61/80) cases, intussusception was reduced within 20 minutes. In 14 (17.5%) patients, reduction could not be achieved (gangrenous gut=5, Meckel’s diverticulum=3, illeo-illeal intussusception=1, perforation=5). Recurrence rate of intussusception was 7.5% (n=6/80), including 4 (5%) cases within 24 hours and 2 (2.5%) cases within 2 months after reduction. CONCLUSION: Ultrasound guided hydrostatic reduction of intussusception is an effective way to reduce intussusception, especially in patients presenting within two days.

The radiological characteristics of childhood intussusception including unusual features and rare pathological lead points

PurposeTo describe the radiological characteristics for childhood intussusceptions including unusual radiological features and rare pathological lead points (PLP). Material and methodsThe medical records of all childhood intussusceptions between 1/1/2010 -1/10/2020 were retrospectively reviewed. 95 cases were identified in 82 patients. The demographic data, presenting symptoms, diagnostic and treatment methods, radiological features, and PLPs among the different types of intussusception were analyzed. ResultsIleocolic intussusception (ICI) represented 53.7% (51/95). The average age for ICI was 1.87 years. Males constituted 72.1% (31/43). 29.4% (15/51) were treated primarily surgically due to peritonitis. Small bowel intussusception (SBI) represented 40% (38/95) in which females constituted 51.5% (17/33). Ileo-ileal represented 63.2% (24/38). 81.8% (27/33) were transient. On ultrasound; There was a statistically significant difference in the size of the outer diameter of ICI compared to SBI (P-value 0.00012). Ileo-ileocolic and colo-colic intussusceptions constituted 3.2% (3/95); each and were more common in females. Vomiting was the most common symptom for intussusception and ultrasound was diagnostic in the majority of cases. PLPs were seen in 36.6% (30/82) of the patients of which the average age was 7 years. PLPs/risk factors were benign in 80% (24/30). A case of colo-colic intussusception was seen in a 16-year-old female due to clear cell sarcoma which was not reported before. 12.2% patients (10/82) had recurrent intussusception. ConclusionOur study showed that ICI is the most commonly encountered type. SBIs are mostly transient. It is important to radiologically determine the type of intussusception and to identify PLPs or unusual radiological features to avoid unnecessary intervention and significant patient morbidity.

Use of Plane X-Ray for Nonoperative Treatment of Intussusception at Resource Limited Settings in Low-and Middle-Income Countries

Objective: To report an easy and feasible technique of hydrostatic reduction of intussusception using plane x-ray in resource limited setting and summarize the radiological findings. Method: Records of all patients of hydrostatic reduction between May 2015 and April 2020 were retrospectively evaluated to document patient demography, seasonal variations, type of intussusception, duration of procedure, number of x-ray exposures, reflux of contrast through ileocecal valve, location of intussusception mass, presence of redundant colon and outcome. Hydrostatic reduction was performed with water soluble contrast using intermittent shots of plane x-ray, instead of ultrasound (US) or fluoroscopy guidance. Results: Among a total of 204 patients, male to female ratio was 1.7:1. Age ranged from 5 days to 16 years (median 10 months). There were more cases during Winter and Spring (110, 53.9%). Right hepatic flexure was the commonest (115, 56.4%) site of obstruction. Hydrostatic reduction was successful in 172 (84.3%) patients. Median duration of the procedure was 27 minutes and, on an average, 8.4 ± 1.7 exposures were needed for one hydrostatic reduction. There was no significant relation of age group and sex with successful hydrostatic reduction but site of obstruction was significantly related with success (p=0.00). There was one (0.5%) recurrence and no mortality. Conclusion: Hydrostatic reduction using contrast enema under x-ray guidance is a rational alternative to US or fluoroscopy guided reduction in resource limited settings.

Most Adult Intussusceptions are Caused by Tumors: A Single-Centre Analysis.

BackgroundAdult intussusception is less common than paediatric intussusception. The aim of this study was to explore the clinical presentation, aetiology, diagnosis and treatment of adult intussusception.MethodsAdults (>18 years) with intussusception treated by surgical or conservative measures were included from January 2005 to January 2018, and the manifestation, types, diagnosis and treatment of adult intussusception in our centre were reviewed.ResultsA total of 150 patients with adult intussusception were included in this study. The clinical manifestations included 111 cases (74%) of abdominal pain, 38 cases (25.3%) of bloody stool, 37 cases (24.7%) of bowel obstructions, 33 cases (22%) of abdominal distension, 29 cases (19.3%) of nausea and vomiting, 19 cases (12.7%) of an abdominal mass, and 12 cases (8.0%) of diarrhoea. The types of intussusception were classified into 36 cases (24%) of enteric intussusception, 87 cases (58%) of intestine-colon intussusception and 27 cases (18%) of colonic intussusception. Surgical intervention was applied in 139 cases (92.7%), including 115 patients who underwent open surgery, and laparoscopy-assisted surgery was performed in 24 patients. The main pathogenesis of intussusception was malignant tumors in 51 cases (36.7%) and benign tumors and polyps in 49 cases (35.3%).ConclusionMalignant and benign tumors are the main causes of adult intussusception. Abdominal CT is the preferred evaluation method for the preoperative diagnosis of this condition. The choice of surgical procedure depends on the location and type of intussusception.

STUDY OF VARIOUS TYPES OF TREATMENT MODALITIES IN CHILDREN WITH INTUSSUSCEPTION

Background:Intussusception is a condition in which one part of gut enters into another part of gut known as telescoping. Ultrasonography of abdomen is highly specific and sensitive for diagnosis. Most of the ileo-ileal and fewer ileo-colic intussusceptions may reduce spontaneously. Ultrasound guided reduction is an alternative to surgery. If intussusception is not treated timely it may cause intestinal ischemia, gangrene, perforation peritonitis, shock and death. Method:This is a hospital based prospective study including 96 patients over a period of 18 months. Detailed proforma was used, including name, age, sex, weight, presenting complaints, duration of complaints, abdominal sign &amp; symptoms, signs of the sepsis &amp; shock, peritonitis, perforation, USG finding, and type of surgery performed. The presence of the complications also noted. Results:Maximum patients (63.5%) of intussusception diagnosed were between 6 months to two years. Out of total 96 patients, 21 were treated by pneumatic reduction successfully. In 46 patient exploratory laparotomy and intra-operative reduction done, while in 29 children required resection anastomosis. Most common complaint was abdominal pain (100%) followed by Excessive cry (92.7%). Most common type of intussusception was Ileo-colic(88.5%). Respiratory distress (23.9%) followed by septicemia (20.8%) was the most common complications. Conclusions:Intussusception is a common surgical problem in childhood. Children of age 6 month to 2 years of age are affected most commonly. Ileo-colic is the most common type. Ultrasonography is diagnostic as well as therapeutic tool for intussusception. USG guided pneumatic reduction is a simple and good technique, if patient comes to hospital earlier. Early diagnosis of signs and symptoms may help clinician to take early interventions to save the gut as well life of the patient.