F A Abantanga1, M Amoah, A O Adeyinka, B Nimako, K P Yankey. 1. Department of Surgery, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science & Technology, Kumasi, Ghana.
Abstract
OBJECTIVE: To evaluate the role of pneumatic reduction in the management of intussusception in children in the setting of a sub-Saharan African nation. DESIGN: Prospective case series. SETTING: Tertiary care teaching hospital in Kumasi, Ghana. SUBJECTS: Forty four children, aged 4 months to 13 years, 28 boys and 16 girls, were admitted with a clinical diagnosis of intussusception and confirmed by ultrasonography. INTERVENTIONS: Twenty two children had air enema reduction of the intussusception attempted in the operation theatre under general anaesthesia. The average pressure used for air enema reduction of the intussusceptions was 110.4 mm Hg. MAIN OUTCOME MEASURES: Success of pneumatic reduction, morbidity and mortality. RESULTS: Overall air enema reduction of intussusception was successful in 59.1% of children who underwent this procedure. There were no deaths among children who had a successful air enema reduction of intussusception. One child (11.1%) out of nine who had laparotomy done after a failed pneumatic reduction died. The average length of hospital stay was shorter in those with successful air enema reduction (3.8 +/- 2.3 days, 95% Confidence Interval [CI] = 2.4 to 5.2) than those who had a laparotomy performed for manual reduction of the intussusception after a failed pneumatic reduction (6.7 +/- 5.1 days, 95% CI = 33 to 9.9). CONCLUSION: Although the sample size is small, pneumatic reduction of intussusception in children without peritonitis is possible, practical, and reliable and must be tried first, preferably under general anaesthesia in our sub-region before proceeding to laparotomy in case of failure.
OBJECTIVE: To evaluate the role of pneumatic reduction in the management of intussusception in children in the setting of a sub-Saharan African nation. DESIGN: Prospective case series. SETTING: Tertiary care teaching hospital in Kumasi, Ghana. SUBJECTS: Forty four children, aged 4 months to 13 years, 28 boys and 16 girls, were admitted with a clinical diagnosis of intussusception and confirmed by ultrasonography. INTERVENTIONS: Twenty two children had air enema reduction of the intussusception attempted in the operation theatre under general anaesthesia. The average pressure used for air enema reduction of the intussusceptions was 110.4 mm Hg. MAIN OUTCOME MEASURES: Success of pneumatic reduction, morbidity and mortality. RESULTS: Overall air enema reduction of intussusception was successful in 59.1% of children who underwent this procedure. There were no deaths among children who had a successful air enema reduction of intussusception. One child (11.1%) out of nine who had laparotomy done after a failed pneumatic reduction died. The average length of hospital stay was shorter in those with successful air enema reduction (3.8 +/- 2.3 days, 95% Confidence Interval [CI] = 2.4 to 5.2) than those who had a laparotomy performed for manual reduction of the intussusception after a failed pneumatic reduction (6.7 +/- 5.1 days, 95% CI = 33 to 9.9). CONCLUSION: Although the sample size is small, pneumatic reduction of intussusception in children without peritonitis is possible, practical, and reliable and must be tried first, preferably under general anaesthesia in our sub-region before proceeding to laparotomy in case of failure.
Authors: Hope Glover-Addy; Daniel Ansong; Christabel Enweronu-Laryea; Jacqueline E Tate; Kwame Amponsa-Achiano; Badu Sarkodie; Jason M Mwenda; Stanley Diamenu; Sandra Kwarteng Owusu; Boateng Nimako; Nicholas Karikari Mensah; Joseph Armachie; Clement Narh; Kimberly Pringle; Scott P Grytdal; Fred Binka; Ben Lopman; Umesh D Parashar; George Armah Journal: Pan Afr Med J Date: 2021-07-29