Gaurav Jindal1,2, Brendon L Graeber1, Lawrence H Staib1, Cicero T Silva3. 1. Department of Radiology & Biomedical Imaging, Yale School of Medicine, 333 Cedar St., P.O. Box 208042, New Haven, CT, 06520, USA. 2. Department of Diagnostic Imaging, Brown Alpert Medical School, Providence, RI, USA. 3. Department of Radiology & Biomedical Imaging, Yale School of Medicine, 333 Cedar St., P.O. Box 208042, New Haven, CT, 06520, USA. cicero.silva@yale.edu.
Abstract
BACKGROUND: Intussusception is one of the most common causes of acute abdominal emergency in children. Image-monitored pressure reduction is the first line of treatment. OBJECTIVE: We report on a modified technique of air delivery during fluoroscopic-monitored pneumatic intussusception reductions, and compare it with an established technique. MATERIALS AND METHODS: We modified the Shiels intussusception reduction device so that the air used for intussusception reduction is delivered not by the device's insufflator bulb, but rather by the hospital medical air supply system, eliminating the need for continuous pumping of the insufflator bulb during the procedure. Subsequently, we retrospectively compared sequential fluoroscopy-monitored pneumatic intussusception reduction procedures performed in patients younger than 18 years using either the standard or modified devices, evaluating technical procedure parameters (i.e. median procedure time length, fluoroscopy time length and radiation dose) and patient outcomes (i.e. number of complete intussusception reductions, number of incomplete intussusception reductions, number of intussusception recurrences within 3 days of the procedure, number of procedures followed by surgery). RESULTS: We found no statistically significant differences between procedures performed with the standard and modified techniques. CONCLUSION: The device modification allows for increased operator comfort. Evaluated procedure parameters and patient outcomes appear similar to those of the standard technique.
BACKGROUND: Intussusception is one of the most common causes of acute abdominal emergency in children. Image-monitored pressure reduction is the first line of treatment. OBJECTIVE: We report on a modified technique of air delivery during fluoroscopic-monitored pneumatic intussusception reductions, and compare it with an established technique. MATERIALS AND METHODS: We modified the Shiels intussusception reduction device so that the air used for intussusception reduction is delivered not by the device's insufflator bulb, but rather by the hospital medical air supply system, eliminating the need for continuous pumping of the insufflator bulb during the procedure. Subsequently, we retrospectively compared sequential fluoroscopy-monitored pneumatic intussusception reduction procedures performed in patients younger than 18 years using either the standard or modified devices, evaluating technical procedure parameters (i.e. median procedure time length, fluoroscopy time length and radiation dose) and patient outcomes (i.e. number of complete intussusception reductions, number of incomplete intussusception reductions, number of intussusception recurrences within 3 days of the procedure, number of procedures followed by surgery). RESULTS: We found no statistically significant differences between procedures performed with the standard and modified techniques. CONCLUSION: The device modification allows for increased operator comfort. Evaluated procedure parameters and patient outcomes appear similar to those of the standard technique.
Entities:
Keywords:
Air enema; Children; Device; Fluoroscopy; Intussusception