Intussusception reduction

Perforation during attempted intussusception reduction in children—A comparison of perforation with barium and air

Journal of Pediatric Surgery ◽

10.1016/s0022-3468(96)90364-4 ◽

1996 ◽

Vol 31 (1) ◽

pp. 210

Author(s):

Martin T Corbally

Keyword(s):

Intussusception Reduction

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General anesthesia for intussusception reduction by enema

Pediatric Anesthesia ◽

10.1111/pan.12035 ◽

2012 ◽

Vol 22 (12) ◽

pp. 1211-1215 ◽

Cited By ~ 19

Author(s):

Emilien Purenne ◽

Stéphanie Franchi-Abella ◽

Sophie Branchereau ◽

Catherine Baujard ◽

Dan Benhamou ◽

...

Keyword(s):

General Anesthesia ◽

Intussusception Reduction

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Indications for repeated enema reduction of intussusception in children

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1406320v ◽

2014 ◽

Vol 142 (5-6) ◽

pp. 320-324 ◽

Cited By ~ 5

Author(s):

Dragana Vujovic ◽

Marija Lukac ◽

Aleksandar Sretenovic ◽

Tamara Krstajic ◽

Vesna Ljubic ◽

...

Keyword(s):

Operative Treatment ◽

Therapeutic Option ◽

Operative Procedure ◽

Predictor Variable ◽

Symptom Duration ◽

Ultrasound Guided ◽

Abdominal Emergency ◽

Presenting Symptoms ◽

Intussusception Reduction ◽

Enema Reduction

Introduction. Intussusception is a common abdominal emergency in early childhood. It is idiopathic in more than 90% of cases with incidence of 1.5-4 per 1,000 live births. The treatment of choice is nonoperative hydrostatic or air enema reduction. Objective. The aim of the study was to evaluate the influence of clinical presentation and symptom duration in non-operative treatment, considering the indications for delayed enema reduction and its efficacy. Methods. From the total number of 107 patients with intusussception, aged from 2 months to 14 years (median 9 months), 102 (95%) patients with ileo-colic intussusceptions were treated initially by ultrasound guided saline enema. Records were reviewed for patients with failed initial treatment and delayed repeated enemas or operative procedure. The predictor variable included duration of presenting symptoms. Results. Successful treatment by hydrostatic saline enemas had 58/102 (57%) patients. Success in reduction was greater if symptom duration was <24 hours (54/62 cases; 87%, p<0.001), compared with >24 hours, (4/45 cases; 9%). Despite failed initial attempts, enema reduction was reattempted in 12 patients, with success in 7/12 (60%) patients. Children with symptom duration >24 hours had a greater risk of requiring surgery (41/45 cases; 91%, p<0.001), including 5 (5%) patients with ileo-ileal intussusceptions. Conclusion. The accuracy of ultrasound guided saline enema in intussusception reduction is high. Delay in presentation decreases success of non-operative treatment. Delayed enema reduction is important therapeutic option for intussusceptions. Surgical treatment is indicated in cases of complications.

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Inpatient Admission versus Emergency Department Management of Intussusception in Children: A Systemic Review and Meta-Analysis of Outcomes

European Journal of Pediatric Surgery ◽

10.1055/s-0038-1668145 ◽

2018 ◽

Vol 29 (01) ◽

pp. 007-013 ◽

Cited By ~ 3

Author(s):

Sanjena Amuddhu ◽

Yong Chen ◽

Shireen Nah

Keyword(s):

Emergency Department ◽

Recurrence Rate ◽

Meta Analysis ◽

Length Of Hospital Stay ◽

Early Recurrence ◽

Contrast Enema ◽

Systemic Review ◽

Recurrence Rates ◽

Emergency Department Management ◽

Intussusception Reduction

Introduction Recent literature advocates outpatient emergency department (ED) management of intussusception citing low recurrence rates and postreduction events after uncomplicated ileocolic reduction. However, few studies include both inpatient and outpatient cohorts. We performed a systematic review and meta-analysis to compare recurrence rates and length of hospital stay between the groups. Materials and Methods Studies published in English up to January 2018 were searched from Medline, Embase, Google Scholar, and Cochrane databases, using a combination of the terms ‘intussusception,’ ‘reduction,’ and ‘management’. A meta-analysis of studies comparing outcomes after successful intussusception reduction in children between inpatients and ED patients was performed. Results No randomized controlled trials (RCT) were found. Nine observational studies (eight retrospective and one prospective) were included, comprising 546 inpatients and 776 ED cases. There was no statistical difference in overall recurrence rate between inpatients (8.8%) and ED (10.1%) (pooled odds ratio [OR] = 1.09; 95% confidence interval [CI] 0.74–1.62; P = 0.66; I 2 = 0). Five studies reported early recurrence (<48 hours) with no difference (pooled OR = 1.27; 95% CI 0.46–3.48; P = 0.65; I 2 = 0). Five studies reported postdischarge recurrence rate with no difference (pooled OR = 1.57; 95% CI 0.71–3.48; P = 0.27; I 2 = 34%). Five studies reported recurrence requiring surgery with no difference (pooled OR = 0.99; 95% CI 0.32–3.06; P = 0.99; I 2 = 0). Methods of reduction were air, barium, or other contrast enema. Conclusion Management of intussusception in the ED after uncomplicated reduction appears acceptable. However, evidence levels are low, and RCT should be performed to adequately evaluate the safety of outpatient management of pediatric intussusception.

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