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Erschienen in: Pediatric Surgery International 7/2016

06.05.2016 | Original Article

Ultrasound-guided reduction of intussusception: a safe and effective method performed by pediatric surgeons

verfasst von: Stefan Gfroerer, Henning Fiegel, Udo Rolle

Erschienen in: Pediatric Surgery International | Ausgabe 7/2016

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Abstract

Objectives

Ultrasound has developed as the method of choice for diagnosing intussusception. Ultrasound-guided enema reduction is the standard method for treating intussusception. This retrospective study evaluates the efficacy and safety of ultrasound in diagnosis and treatment of intussusception performed solely by pediatric surgeons.

Methods

Charts were studied of all patients who were treatedfor intussusception in our unit from 2013 to 2015. Primary outcome measure was the completeness of reduction, and secondary outcome measure was the rate of complications and elapsed time until surgical treatment.

Results

We included 38 patients in this retrospective study. The mean age was 16.7 months (±15), and the female to male ratio was 1:2. Diagnosis was established by abdominal ultrasound. Thirty-five of thirty-eight patients underwent ultrasound-guided enema reduction at our institution. Three of thirty-eight patients were scheduled for immediate surgery due to signs of peritonitis or prolonged bowel obstruction. The overall rate of successful ultrasound enema reduction was 28/35 (80 %) patients. Seven of thirty-five patients underwent surgery after an unsuccessful enema reduction; 6/7 patients had a prolonged history of symptoms, and 6/7 patients had a specific pathological lead point. The length of hospitalization was less than 2 days for patients after enema reduction. Recurrence was observed in three cases (8.5 %). We did not observe any complications during enema reduction.

Conclusions

Ultrasound-guided enema reduction for intussusception is safe and effective when performed by pediatric surgeons.
Literatur
1.
Zurück zum Zitat Stokes SM, Iocono JA, Brown S et al (2014) Intussusception clinical pathway: a survey of pediatric surgery practices. Am Surg 80(9):846–848PubMed Stokes SM, Iocono JA, Brown S et al (2014) Intussusception clinical pathway: a survey of pediatric surgery practices. Am Surg 80(9):846–848PubMed
2.
Zurück zum Zitat Nguyen HN, Kan JH, Guillerman RP et al (2014) Intussusception revisited: is immediate on-site surgeon availability at the time of reduction necessary? AJR Am J Roentgenol 202(2):432–436CrossRefPubMed Nguyen HN, Kan JH, Guillerman RP et al (2014) Intussusception revisited: is immediate on-site surgeon availability at the time of reduction necessary? AJR Am J Roentgenol 202(2):432–436CrossRefPubMed
3.
Zurück zum Zitat Bai YZ, Qu RB, Wang GD et al (2006) Ultrasound-guided hydrostatic reduction of intussusceptions by saline enema: a review of 5218 cases in 17 years. Am J Surg 192(3):273–275CrossRefPubMed Bai YZ, Qu RB, Wang GD et al (2006) Ultrasound-guided hydrostatic reduction of intussusceptions by saline enema: a review of 5218 cases in 17 years. Am J Surg 192(3):273–275CrossRefPubMed
4.
Zurück zum Zitat Lehnert T, Sorge I, Till H et al (2009) Intussusception in children—clinical presentation, diagnosis and management. Int J Colorectal Dis 24(10):1187–1192CrossRefPubMed Lehnert T, Sorge I, Till H et al (2009) Intussusception in children—clinical presentation, diagnosis and management. Int J Colorectal Dis 24(10):1187–1192CrossRefPubMed
5.
Zurück zum Zitat Territo HM, Wrotniak BH, Qiao H et al (2014) Clinical signs and symptoms associated with intussusception in young children undergoing ultrasound in the emergency room. Pediatr Emerg Care 30(10):718–722CrossRefPubMed Territo HM, Wrotniak BH, Qiao H et al (2014) Clinical signs and symptoms associated with intussusception in young children undergoing ultrasound in the emergency room. Pediatr Emerg Care 30(10):718–722CrossRefPubMed
6.
Zurück zum Zitat Karadag CA, Abbasoglu L, Sever N et al (2015) Ultrasound-guided hydrostatic reduction of intussusception with saline: safe and effective. J Pediatr Surg 50(9):1563–1565CrossRefPubMed Karadag CA, Abbasoglu L, Sever N et al (2015) Ultrasound-guided hydrostatic reduction of intussusception with saline: safe and effective. J Pediatr Surg 50(9):1563–1565CrossRefPubMed
7.
Zurück zum Zitat Digant SM, Rucha S, Eke D (2012) Ultrasound guided reduction of an ileocoloic intussusception by a hydrostatic method by using normal saline enema in paediatric patients: a study of 30 cases. J Clin Diagn Res 6(10):1722–1725PubMedPubMedCentral Digant SM, Rucha S, Eke D (2012) Ultrasound guided reduction of an ileocoloic intussusception by a hydrostatic method by using normal saline enema in paediatric patients: a study of 30 cases. J Clin Diagn Res 6(10):1722–1725PubMedPubMedCentral
8.
Zurück zum Zitat Menke J, Kahl F (2015) Sonography-guided hydrostatic reduction of ileocolic intussusception in children: analysis of failure and success in consecutive patients presenting timely to the hospital. Eur J Pediatr 174(3):307–316CrossRefPubMed Menke J, Kahl F (2015) Sonography-guided hydrostatic reduction of ileocolic intussusception in children: analysis of failure and success in consecutive patients presenting timely to the hospital. Eur J Pediatr 174(3):307–316CrossRefPubMed
9.
Zurück zum Zitat Wood SK, Kim JS, Suh SJ et al (1992) Childhood intussusception: US-guided hydrostatic reduction. Radiology 182(1):77–80CrossRefPubMed Wood SK, Kim JS, Suh SJ et al (1992) Childhood intussusception: US-guided hydrostatic reduction. Radiology 182(1):77–80CrossRefPubMed
10.
Zurück zum Zitat Samad L, Marven S, El Bashir H et al (2012) Prospective surveillance study of the management of intussusception in UK and Irish infants. Br J Surg 99(3):411–415CrossRefPubMed Samad L, Marven S, El Bashir H et al (2012) Prospective surveillance study of the management of intussusception in UK and Irish infants. Br J Surg 99(3):411–415CrossRefPubMed
11.
Zurück zum Zitat Sanchez TR, Doskocil B, Stein-Wexler R (2015) Nonsurgical management of childhood intussusception: retrospective comparison between sonographic and fluoroscopic guidance. J Ultrasound Med 34(1):59–63CrossRefPubMed Sanchez TR, Doskocil B, Stein-Wexler R (2015) Nonsurgical management of childhood intussusception: retrospective comparison between sonographic and fluoroscopic guidance. J Ultrasound Med 34(1):59–63CrossRefPubMed
12.
Zurück zum Zitat Di Renzo D, Colangelo M, Lauriti G et al (2012) Ultrasound-guided Hartman´s solution enema: first choice procedure for reducing idiopathic intussusception. Radiol Med 117(4):679–689CrossRefPubMed Di Renzo D, Colangelo M, Lauriti G et al (2012) Ultrasound-guided Hartman´s solution enema: first choice procedure for reducing idiopathic intussusception. Radiol Med 117(4):679–689CrossRefPubMed
13.
Zurück zum Zitat He N, Zhang S, Ye X et al (2014) Risk factors associated with failed sonographically guided saline hydrostatic intussusception reduction in children. J Ultrasound Med 33(9):1669–1675CrossRefPubMed He N, Zhang S, Ye X et al (2014) Risk factors associated with failed sonographically guided saline hydrostatic intussusception reduction in children. J Ultrasound Med 33(9):1669–1675CrossRefPubMed
14.
Zurück zum Zitat Fallon SC, Lopez ME, Zhang W et al (2013) Risk factors for surgery in pediatric intussusception in the era of pneumatic reduction. J Pediatr Surg 48:1032–1036CrossRefPubMed Fallon SC, Lopez ME, Zhang W et al (2013) Risk factors for surgery in pediatric intussusception in the era of pneumatic reduction. J Pediatr Surg 48:1032–1036CrossRefPubMed
15.
Zurück zum Zitat Beres AL, Baird R, Fung E et al (2014) Comparative outcome analyis of the management of pediatric intussusception with or without surgical admission. J Pediatr Surg 49(5):750–752CrossRefPubMed Beres AL, Baird R, Fung E et al (2014) Comparative outcome analyis of the management of pediatric intussusception with or without surgical admission. J Pediatr Surg 49(5):750–752CrossRefPubMed
16.
Zurück zum Zitat Gray MP, Li SH, Hoffmann RG et al (2014) Recurrence rates after intussusception enema reduction: a meta-analysis. Pediatrics 134(1):110–119CrossRefPubMed Gray MP, Li SH, Hoffmann RG et al (2014) Recurrence rates after intussusception enema reduction: a meta-analysis. Pediatrics 134(1):110–119CrossRefPubMed
17.
Zurück zum Zitat Hannon E, Williams R, Allan R et al (2014) UK intussusception audit: a national survey of practice and audit of reduction rates. Clin Radiol 69(4):344–349CrossRefPubMed Hannon E, Williams R, Allan R et al (2014) UK intussusception audit: a national survey of practice and audit of reduction rates. Clin Radiol 69(4):344–349CrossRefPubMed
18.
Zurück zum Zitat Cullmann JL, Heverhagen JT, Puig S (2015) Radiation dose in pneumatic reduction of ileo-colic intussusceptions—results from a single-institution study. Pediatr Radiol 45(5):675–677CrossRefPubMed Cullmann JL, Heverhagen JT, Puig S (2015) Radiation dose in pneumatic reduction of ileo-colic intussusceptions—results from a single-institution study. Pediatr Radiol 45(5):675–677CrossRefPubMed
19.
Zurück zum Zitat Shiels WE II (2013) Childhood intussusception: the safety case. Pediatr Radiol 43(6):659–661CrossRefPubMed Shiels WE II (2013) Childhood intussusception: the safety case. Pediatr Radiol 43(6):659–661CrossRefPubMed
20.
Zurück zum Zitat McAteer JP, Kwon S, LaRiviere CA et al (2013) Pediatric specialist care is associated with a lower risk of bowel resection in children with intussusception: a population-based analysis. J Am Coll Surg 217(2):226–232CrossRefPubMed McAteer JP, Kwon S, LaRiviere CA et al (2013) Pediatric specialist care is associated with a lower risk of bowel resection in children with intussusception: a population-based analysis. J Am Coll Surg 217(2):226–232CrossRefPubMed
Metadaten
Titel
Ultrasound-guided reduction of intussusception: a safe and effective method performed by pediatric surgeons
verfasst von
Stefan Gfroerer
Henning Fiegel
Udo Rolle
Publikationsdatum
06.05.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Surgery International / Ausgabe 7/2016
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-016-3898-x

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