Childhood intussusception: a 9-year review

Ugwu, B T; Legbo, J. N.; Dakum, NK; Yiltok, SJ; Mbah, N; Uba, Francis A

doi:10.1080/02724936.2000.11748122

Cited by 56 publications

(82 citation statements)

References 15 publications

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“…Guo et al excluded all patients who had severe rectal bleeding, severe dehydration and abdominal distension from air enema reduction in a large series of children with intussusception [10]. A prolapsing rectal mass was considered a late feature of the disease and hence a contraindication [12,13].…”

Section: Discussionmentioning

confidence: 99%

Air enema for intussusception: Is predicting the outcome important?

et al. 2007

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Air enema is the treatment of choice for childhood intussusceptions. Although peritonitis is the established contraindication, studies have attempted to identify factors that affect the outcome of air enema. In our series we studied the impact of such factors on the clinical scenario to determine if it was important to predict the outcome of air enema. We retrospectively reviewed the records of 179 children who underwent air enema for intussusception at our institution over a 5-year period. Abdominal colic was present in 144 children, vomiting in 139 and rectal bleeding in 108 children. The duration of symptoms was less than 24 h in 131 children. An abdominal mass was present in 121 children, rectal prolapse of intussusception in 14, dehydration in 31 and small bowel obstruction in 27 children. The success rate of air enema was calculated. All clinical features were analyzed for impact on outcome using univariate and multivariate analysis. The extent of this impact on the clinical scenario was examined. Air enema was successful in 157 cases (89%). One child developed a perforation during the procedure (0.6%). The recurrence rate was 8%. Using chi2 test, success of air enema was reduced in the presence of rectal bleeding, rectal prolapse of intussusception, dehydration, and small bowel obstruction. This reduction was statistically significant (P < 0.05). Using logistic regression analysis, the success of air enema was significantly reduced (P < 0.05) only in the presence of prolapsing rectal intussusception (57%) and small bowel obstruction (52%). Small bowel obstruction and prolapsing rectal intussusceptions merely reduce the success of air enema and do not increase the complications. Since the success of air enema is very high, it must be attempted in all children with the exception of peritonitis. Predicting the outcome is not crucial because of the high success rate and low complication rate.

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Section: Discussionmentioning

confidence: 99%

Air enema for intussusception: Is predicting the outcome important?

et al. 2007

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“…Serology and virus isolation from fecal and pharyngeal swabs have shown that viral and bacterial agents are associated with intussusception [6,10]. The association of rotavirus vaccine (RRV-TV, RotaShield) with intussusception led to the removal of the product from the market in 1999 [11].…”

Section: Presentation and Clinical Findingsmentioning

confidence: 99%

“…The incidence of intussusception in infants ranges from 0.3 to 4 cases per 1,000 live births in Europe, North America and Australia, but in some developing countries a higher incidence and a high rate of complications have been described [4,6].…”

Section: Introductionmentioning

confidence: 98%

Current radiological management of intussusception in children

et al. 2007

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Intussusception is the most common abdominal emergency situation in infants and small children. There has been great progress in diagnostic and therapeutic management of intussusception. Ultrasound (US) has been shown to be the first-choice imaging technique in diagnosing intussusception for reasons of high accuracy, simultaneous exclusion of differential diagnoses, and disclosure of additional pathologies. Controversial opinions exist worldwide concerning the nonoperative treatment of intussusception in infants and children. Pneumatic reduction under fluoroscopic guidance and hydrostatic reduction under US monitoring are the preferred techniques. The aim should be a success rate of at least 90% in idiopathic intussusception. This review summarizes different types of intussusception and outlines diagnostic aspects as well as several treatment concepts.

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“…The 'target sign' described in literature is very useful and can be easily picked up by linear transducer (7.5-10 MHZ) (3,7,13,19) even by an inexperienced radiologist. A small amount of free fluid in the peritoneum is common in most cases of intussusception (2,3,5).…”

Section: Discussionmentioning

confidence: 99%

“…Clinical examination may reveal a sausage shaped lump, with concavity towards the umbilicus and emptiness of the right iliac fossa (sign of Dance) (3,5,13,19). If untreated, the bowel loop may become gangrenous, resulting in sloughing, perforation and peritonitis, and may eventually lead to death (3,7,13,19).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided reduction of ileocolic intussusception in children

2016

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Objective -To determine the success rate of the newly introduced method of ultrasound guided hydrostatic reduction in detected ileocolic intussusception by retrospective analysis. Materials and methods -Analysis was performed on all diagnosed ileocolic intussusceptions during the period of December 2013 to November 2015 at the Department for pediatric Radiology of the Children's Hospital Zagreb. In this period of time 34 patients were diagnosed with ileocolic intussusception. Ultrasound guided hydrostatic reduction was performed in 31 patients. We performed ultrasound guided hydrostatic reposition using saline solution warmed at body temperature. Saline was applied per rectum. When the intussusceptum crossed the ileocecal valve, the reposition was considered successful. Results -Out of 34 patients, three patients were treated with an urgent surgical procedure, while ultrasound guided hydrostatic reduction was performed in 31 patients. The non-surgical procedures were successful in all cases and complete reductions of intussusception were achieved in all 31 patients. In three patients, reinvagination occurred within the first 48 hours. Conclusion -Ultrasound guided hydrostatic reduction of ileocolic intussusceptions in children is a very simple and effective technique. The success rate was 91.2% (31/34). The recurrence rate was 8.8%.

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Childhood intussusception: a 9-year review

Cited by 56 publications

References 15 publications

Air enema for intussusception: Is predicting the outcome important?

Air enema for intussusception: Is predicting the outcome important?

Current radiological management of intussusception in children

Ultrasound-guided reduction of ileocolic intussusception in children

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