DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20200099

Ultrasound guided hydrostatic enema reduction of acute intussusception: guidelines in therapy and review of the institutional experience

Vivek Parameswara Sarma

Abstract


Background: In this review, author analyzed the cases of Acute Intussusception that underwent Ultrasound guided hydrostatic reduction during a one-year period. Author reviewed this treatment protocol and guidelines of non-operative and surgical therapy. The procedure followed and guidelines of therapy were reviewed and are detailed in the study.

Methods: Retrospective analysis of the hospital data of all patients who were treated for acute Intussusception during the period of January 2017 to December 2017 was done. All records including admission data, investigations, procedure records, preoperative details and operation notes, where applicable, post procedure recovery data and incidence of recurrence were studied. Inclusion criteria included confirmed sonological diagnosis of Intussusception verified by the treating paediatric surgeon, availability of all necessary records and absence of other co-morbidities. Exclusion criteria included age more than 2 years, children who had other major systemic disease, doubtful sonological diagnosis and postoperative intussusception. The paediatric surgeon himself performed the procedure in the dedicated ultrasound suite.

Results: The study was done in the mother and child wing of a medical college which is a tertiary referral centre catering to more than 200 cases of Intussusception per year. The records of 194 cases of Intussusception were available for analysis, of which only 176 could be included in the study. The age group included is 3 months to 3 years. The mean age was 11 months. The sex incidence was 94 cases in males and 82 in females.

Conclusions: Ultrasound guided hydrostatic reduction is a safe, effective and convenient modality for treatment of acute Intussusception, which can be performed by the treating Paediatric surgeon himself with requisite training and exposure.


Keywords


Honeycomb sign, Hydrostatic reduction, Intussusception, Target sign, Ultrasound guided

Full Text:

PDF

References


Liu SJ. Enema reduction of intussusception by hydrostatic pressure under ultrasound guidance: a report of 377 cases. J Pediatr Surg. 1988 Sep 1;23(9):814-8.

Khong PL, Peh WC, Lam CH, Chan KL, Cheng W, Lam WW, et al. Ultrasound-guided hydrostatic reduction of childhood intussusception: technique and demonstration. Radiographics. 2000;20(5):1-.

Daneman A, Navarro O. Intussusception. Pediatr Radiol. 2003;33(2):79-85.

Sarin YK, Rao JS, Stephen E. Ultrasound guided water enema for hydrostatic reduction of childhood intussusception-a preliminary experience. Ind J Radiol Imaging. 1999;9(2):59.

Hameed S. Ultrasound guided hydrostatic reduction in the management of intussusception. Ind J Pediatr. 2006;73(3):217-20.

Henry PY, Joseph JS. Childhood intussusception-Saline hydrostatic reduction under ultrasound guidance: a prospective study. J Ind Assoc Pediatr Surg. 2000;5(2):51.

Van den Ende ED, Allema JH, Hazebroek FW, Breslau PJ. Success with hydrostatic reduction of intussusception in relation to duration of symptoms. Archiv Dis Childhood. 2005;90(10):1071-2.

González-Spínola J, Del Pozo G, Tejedor D, Blanco A. Intussusception: the accuracy of ultrasound-guided saline enema and the usefulness of a delayed attempt at reduction. J Pediatr Surg. 1999;34(6):1016-20.

Eklöf OA, Johanson L, Löhr G. Childhood intussusception: hydrostatic reducibility and incidence of leading points in different age groups. Pediatric Radiol. 1980;10(2):83-6.

Del-Pozo G, Albillos JC, Tejedor D, Calero R, Rasero M, de-la-Calle U, et al. Intussusception in children: current concepts in diagnosis and enema reduction. Radiographics. 1999;19(2):299-319.