Pneumatic reduction in the treatment of childhood intussusception cases: Çocukluk çağı invajinasyon olgularında pnömatik  redüksiyon sonuçları

Mevlit Korkmaz; Hamza Yazgan; Kürşat Budan; Feride Korkmaz; Esengül Keleş; Arzu Gebeşce; Mehmet  Demirdöven; Ömer Etlik

doi:10.5455/GMJ-30-2012-70

Authors

Mevlit Korkmaz Özel Sema Hastanesi, Çocuk Cerrahisi Bölümü, İstanbul
Hamza Yazgan Özel Sema Hastanesi, Çocuk Sağlığı ve Hastalıkları Bölümü, İstanbul
Kürşat Budan Özel Sema Hastanesi, Çocuk Cerrahisi Bölümü, İstanbul
Feride Korkmaz Özel Sema Hastanesi, Anestezi ve Reanimasyon Bölümü, İstanbul
Esengül Keleş Özel Sema Hastanesi, Çocuk Sağlığı ve Hastalıkları Bölümü, İstanbul
Arzu Gebeşce Özel Sema Hastanesi, Çocuk Sağlığı ve Hastalıkları Bölümü, İstanbul
Mehmet Demirdöven Özel Sema Hastanesi, Çocuk Sağlığı ve Hastalıkları Bölümü, İstanbul
Ömer Etlik Özel Sema Hastanesi, Radyoloji Bölümü, İstanbul

DOI:

https://doi.org/10.5455/GMJ-30-2012-70

Keywords:

Childhood, intussusceptions, pneumatic reduction

Abstract

Intussusception that is defined as insertion of proximal intestine into distal segment is the second most common acute abdomen pathology after appendicitis. In this retrospective study, we evaluated the patients presented with intussusception and the results of pneumatic reduction. A retrospective analysis of files and operation logs of patients with intussusception from 2007 to 2011 were done. In this study, 13 male (72,2%) and 5 female (27,8%), totally 18 patients were analyzed. Mean age was 20,36 months (6,5-95 months). The most common clinical presentations were abdominal pain, vomiting, bloody stool and irritability and duration of complains were 6-52 hours. Although in all patients signs of intussusception were found on abdominal ultrasound examination, in 8 (44%) patients abdominal mass was detected on physical examination. In 15 (83,3%) patients pneumatic reduction was successfully performed and manual reduction was done in 3 (16,7%) patients. In conclusion, abdominal ultrasound that was performed in patients presented with abdominal pain and vomiting may affect the rate of early diagnosis of intussusception. In these patients, pneumatic reduction, as a first choice of treatment, can be carried out easily and successfully.

Metrics

Metrics Loading ...

References

Tangi VT, Bear JW, Reid IS, Wright JE. Intussusception in Newcastle in a 25 year period. Aust N Z J Surg 1991;61(8):608- 13.

Beasly SW, Hutson JM, Auldist AW. Essential paediatric surgery.1st ed., London: Arnold; 1996. p. 45-51.

Hamby LG, Fowler CL, Pokony WJ. Intussusception. In: Donellan WL, editor. Abdominal surgery of infancy and childhood. 2nd edition. Luxembourg: Harwood academic publishers; 2001. p. 42/1-42/19.

Page AC, Price JF, Salisbury JR, Howard ER, Karani J. Chronic intussusception. Arch Dis Child 1990;65(1):134-5.

Aschcraft K. Intussusception. In: Aschcraft K, Holter T, editors. Pediatric surgery. Philadelphia: W.B. Saunders Co; 1993. p. 416-9.

Kilic N, Kiristioglu I, Kirkpinar A, Dogruyol H. A very rare cause of intestinal atresia: intrauterine intussusception due to Meckel’s diverticulum. Acta Paediatr 2003;92(6):756-7.

Byrne AT, Geoghegan T, Govender P, Lyburn ID, Colhoun E, Torreggiani WC. The imaging of intussusception. Clin Radiol 2005;60(1):39-46.

Young D. Intussusception. In: O'Neil JA, Rowe MI, Grosfeld JL (eds). Pediatric surgery. St. Louis: Mosby-Year Book Inc, 1998: 1185-98.

Yang CM, Hsu HY, Tsao PN, Chang MH, Lin FY. Recurrence of intussusception in childhood. Acta Paediatr Taiwan 2001;42(3):158-61.

Tiao MM, Wan YL, Ng SH, Ko SF, Lee TY, Chen MC, et al. Sonographic features of small-bowel intussusception in pediatric patients. Acad Emerg Med 2001;8(4):368-73.

Munden MM, Bruzzi JF, Coley BD, Munden RF. Sonography of pediatric small-bowel intussusception: differentiating surgical from nonsurgical cases. AJR Am J Roentgenol 2007;188(1):275-9.

Beasley SW. Current radiological management of intussusception. Pediatr Radiol 1993;23(1):78. 13. Ikeda T, Koshinaga T, Inoue M, Goto H, Sugitou K, Hagiwara N. Intussusception in children of school age. Pediatr Int 2007;49(1):58-63.

Kia KF, Mony VK, Drongowski RA, Golladay ES, Geiger JD, Hirschl RB, et al. Laparoscopic vs open surgical approach for intussusception requiring operative intervention. J Pediatr Surg 2005;40(1):281-4.

Bailey KA, Wales PW, Gerstle JT. Laparoscopic versus open reduction of intussusception in children: a single-institution comparative experience. J Pediatr Surg 2007;42(5):845-8.

Ein SH, Alton D, Palder SB, Shandling B, Stringer D. Intussusception in the 1990s: has 25 years made a difference? Pediatr Surg Int 1997;12(5-6):374-6.

Bonadio WA. Intussusception reduced by barium enema. Outcome and short-term follow-up. Clin Pediatr (Phila) 1988;27(12):601-4.

Kırıştıoğlu I. İnvajinasyonlarda tedavi yaklaşımı. Güncel Pediatri 2004;2(3):131-3.

Tander B, Baskin D, Candan M, Başak M, Bankoğlu M. Ultrasound guided reduction of intussusception with saline and comparison with operative treatment. Ulus Travma Acil Cerrahi Derg 2007;13(4):288-93.

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

Okuyama H, Nakai H, Okada A. Is barium enema reduction safe and effective in patients with a long duration of intussusception? Pediatr Surg Int 1999;15(2):105-7.

Daneman A, Navarro O. Intussusception. Part 2: An update on the evolution of management. Pediatr Radiol 2004;34(2):97- 108.

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.

Hadidi AT, El Shal N. Childhood intussusception: a comparative study of nonsurgical management. J Pediatr Surg 1999;34(2):304-7.

Wood SK, Kim JS, Suh SJ, Paik TW, Choi SO. Childhood intussusception: US-guided hydrostatic reduction. Radiology 1992;182(1):77-80.

Zambuto D, Bramson RT, Blickman JG. Intracolonic pressure measurements during hydrostatic and air contrast barium enema studies in children. Radiology 1995;196(1):55-8.

Chan KL, Saing H, Peh WC, Mya GH, Cheng W, Khong PL, et al. Childhood intussusception: ultrasound-guided Hartmann’s solution hydrostatic reduction or barium enema reduction? J Pediatr Surg 1997;32(1):3-6.

Shiels WE 2nd, Maves CK, Hedlund GL, Kirks DR. Air enema for diagnosis and reduction of intussusception: clinical experience and pressure correlates. Radiology 1991;181(1):169- 72.

Meyer JS, Dangman BC, Buonomo C, Berlin JA. Air and liquid contrast agents in the management of intussusception: a controlled, randomized trial. Radiology 1993;188(2):507-11.

Stringer DA, Ein SH: Pneumatic reduction: advantages, risks and indications. Pediatr Radiol 1990;20(6):475-7.

Zorludemir Ü, Yücesan S, Olcay I. İnvajinasyon: 168 hastanın klinik değerlendirmesi. Pediatrik Cerrahi Dergisi 1987;2:81-9.

Kruatrachue A, Wongtapradit L, Nithipanya N, Ratanaprakarn W. Result of air enema reduction in 737 cases of intussusception J Med Assoc Thai 2011;94 Suppl 3:S22-6.

Lui KW, Wong HF, Cheung YC, See LC, Ng KK, Kong MS, et al. Air enema for diagnosis and reduction of intussusception in children: clinical experience and fluoroscopy time correlation. J Pediatr Surg 2001;36(3):479-81.

Sandler AD, Ein SH, Connolly B, Daneman A, Filler RM. Unsuccessful air-enema reduction of intussusception: is a second attempt worthwhile? Pediatr Surg Int 1999;15(3-4):214- 6.