Debashish Nayak1, S Jagdish. 1. Pediatric Surgery Unit Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, 605 006 India.
Abstract
BACKGROUND: Intussusception is a common cause of acute intestinal obstruction with potentially serious complications. The treatment of choice is an attempt at initial non-operative treatment. AIM: The purpose of the study was to evaluate the efficacy of the technique of hydrostatic reduction of intussusception using saline enema and ultrasound being practiced in our institute; the secondary goal was to identify patient subset in which it is more successful. MATERIAL AND METHODS: The case records of all patients treated for intussusception in our institute from 1st January 2000 to 30th June 2007 were retrospectively analyzed to collect information. All patients with ultrasound diagnosed intussusception that were not having signs of shock or peritonitis were treated with normal saline enema under ultrasound guidance. Failure of three such attempts was an indication for operation. RESULT AND CONCLUSIONS: We found that this technique is easy, safe and extremely effective in treating intussusception in children. The success rate was 81.37% (83 out of 102 cases) and mortality rate was 1.2%. Ileoileocolic type of intussusception failed enema reduction more often (statistically significant; P value = 0.0032) while older patients (statistically significant, P value = 0.001) had higher success rates with the technique. Patients who had colocolic type of intussusception (P value = 0.29) and patients who present early (P value = 0.262) appear to have higher success rates but this was not statistically significant.
BACKGROUND: Intussusception is a common cause of acute intestinal obstruction with potentially serious complications. The treatment of choice is an attempt at initial non-operative treatment. AIM: The purpose of the study was to evaluate the efficacy of the technique of hydrostatic reduction of intussusception using saline enema and ultrasound being practiced in our institute; the secondary goal was to identify patient subset in which it is more successful. MATERIAL AND METHODS: The case records of all patients treated for intussusception in our institute from 1st January 2000 to 30th June 2007 were retrospectively analyzed to collect information. All patients with ultrasound diagnosed intussusception that were not having signs of shock or peritonitis were treated with normal saline enema under ultrasound guidance. Failure of three such attempts was an indication for operation. RESULT AND CONCLUSIONS: We found that this technique is easy, safe and extremely effective in treating intussusception in children. The success rate was 81.37% (83 out of 102 cases) and mortality rate was 1.2%. Ileoileocolic type of intussusception failed enema reduction more often (statistically significant; P value = 0.0032) while older patients (statistically significant, P value = 0.001) had higher success rates with the technique. Patients who had colocolic type of intussusception (P value = 0.29) and patients who present early (P value = 0.262) appear to have higher success rates but this was not statistically significant.
Authors: G del-Pozo; J C Albillos; D Tejedor; R Calero; M Rasero; U de-la-Calle; U López-Pacheco Journal: Radiographics Date: 1999 Mar-Apr Impact factor: 5.333
Authors: Yu Zuo Bai; Ri Bin Qu; Guang Da Wang; Ke Ren Zhang; Yong Li; Ying Huang; Zhi Bo Zhang; Shu Cheng Zhang; Hai Lan Zhang; Xin Zhou; Wei Lin Wang Journal: Am J Surg Date: 2006-09 Impact factor: 2.565