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Ultrasound guided hydrostatic enema reduction of ileocolic intussusception: a safe and effective technique. | LitMetric

AI Article Synopsis

  • The study examines the effectiveness and safety of ultrasound-guided hydrostatic reduction for treating ileocolic intussusception in children, contrasting it with the more common pneumatic reduction method used in most centers.
  • Over nine years, 106 out of 108 patients successfully underwent this technique, achieving a reduction rate of 90.5%, with only 6.25% experiencing recurrence shortly after.
  • The findings suggest that this method is safe, as there were no cases of reduction-related perforation, making it a viable option that minimizes radiation exposure for pediatric patients.

Article Abstract

Background: Currently, the primary management of ileocolic intussusception in children is usually by non-operative image-guided enema reduction. In most centres around the world especially in Australasia the predominant technique is the pneumatic reduction under fluoroscopic guidance. At our institution, we have been performing ultrasound-guided hydrostatic reduction since 2012.This is an audit to determine the efficacy and safety of ultrasound-guided hydrostatic reduction for intussusception.

Methods: Following ethics approval, a retrospective review of all patients presenting to our institution with intussusception and subsequently undergoing hydrostatic reduction over a period of 9 years (2012 to-2020) was performed. The parameters studied included (i) successful reduction, (ii) recurrence, (iii) need for surgery and (iv) lead point at surgery.

Results: The mean age at presentation was 12 months. One hundred and eight children were diagnosed to have ileocolic intussusception. One hundred and six underwent ultrasound-guided hydrostatic reduction with successful reduction in 96 (90.5%) patients. Reduction was unsuccessful in 10 patients (9.5%). Of these eight were noted to have a pathological lead point (four-Meckel's diverticulum and four-Lymphoma) at the time of the surgery. The intussusception recurred in six patients (6.25%) within 24 h. No reduction related perforation occurred during the study period.

Conclusion: Ultrasound-guided hydrostatic reduction is a safe and effective technique for managing intussusception as it allows continuous monitoring of the reduction of the intussusception without exposing the children to ionizing radiation.

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Source
http://dx.doi.org/10.1111/ans.18502DOI Listing

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