Introduction: Intussusception is a pediatric emergency. If it is not treated immediately, the obstruction process can cause arterial obstruction and leads to intestinal necrosis. Not all patient shows classic syndrome triad. Thus, imaging is needed to make the diagnosis. Ultrasonography is the first choice of imaging in children because it is easy, without radiation and sedation. It has high accuracy for the diagnosis of intussusception. Ultrasonographic features of intussusception including target or doughnut sign and pseudo kidney sign. The presence of trapped fluid in intussusception, correlated with intestinal ischemia and necrosis found in surgery. This research aimed to assess sensitivity, specificity, and accuracy of trapped fluid in ultrasound examination compared with the intra-operative findings reported by surgeons in the form of intestinal necrosis in pediatric patients with intussusception in Saiful Anwar Hospital, Malang. Material and Methods: This research was observational analytic with a cross-sectional design. It used retrospective data of abdominal ultrasound results and surgical operating reports in 30 patients who were diagnosed with intussusception. Results: Trapped fluid depiction on ultrasound has a sensitivity of 80%, a specificity of 75%, and an accuracy of 76% with regards to necrotic bowel as compared to intra-operative findings. Conclusion: Trapped fluid in intussusception is a good predictor of intestinal necrosis in cases of intussusception in children.
Background and Purpose: Post-laparotomy adhesion is a problem for surgeons as well as patients. The purpose of this study was to establish a decrease in PAI-1 levels of peritoneal fluid, the degree of adhesion macroscopic and microscopically in male wistar rats subjected to ileum abrasion, between the combination of administration of vitamin E in topical olive oil and injection of Metamizole, single or unstained. Method: Laboratory experimental research. Using 24 male wistar rats which were subjected to ileum abrasion Relaparotomy was performed 14 days later to see the PAI-1 level of the peritoneal fluid, the degree of adhesion macroscopic and the degree of adhesion microscopically. Dataanalysis by ANOVA, Kruskal Wallis, and Spearman test. Result: There was a significant difference in peritoneal fluid PAI-1 levels in the P0-P3 group (p=0.036), but there was no significant difference in peritoneal fluid PAI-1 levels between P0-P1 (p=0.761) and P0-P2 (p= 0.113). There was a significant difference in the P0-P3 group (p=0.005), but there was no significant difference between P0-P2 (p=0.403) and P0-P1 (p=0.187). Correlation test showed a significant correlation between PAI-1 levels of peritoneal fluid and the degree of macroscopic intraperitoneal adhesion with a large correlation of r = 0.750 (macroscopic) and macroscopic intraperitoneal adhesion with a large correlation of r = 0.729 (microscopic).Conclusion: Combination of vitamin E in topical olive oil with metamizole decrease in PAI-1 levels in peritoneal fluid, macroscopic and microscopic degree of adhesion.
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