Effectiveness and safety of ultrasound-guided hydrostatic reduction for children with acute intussusception

Abstract

Objective This study aims to explore the effectiveness and safety of the new-type ultrasound-guided hydrostatic reduction for children with acute intussusception. Methods The clinical data of 364 children with primary acute intussusception who underwent nonsurgical reduction in our hospital between January 2016 and May 2019 were retrospectively analyzed. Among the 364 children, 119 formed the hydrostatic reduction group. There were 89 males and 30 females, and the average age of admission was 25.13 ± 1.43 months. Among the pneumatic reduction group of 245 patients, there were 163 males and 82 females. The average age of admission was 22.47 ± 1.52 months. The reduction rate, length of stay, and perforation rate were compared between the two groups. Results Univariate analysis showed that the reduction rate in the hydrostatic group (94.96%) was higher than in the pneumatic group (85.31%) ( p = 0.007), and the hospital stay (2.76 ± 0.15 days) of the hydrostatic reduction group was shorter than that of the pneumatic reduction group (3.56 ± 0.35 days) ( p = 0.038). In children with intussusception time >48 h, the reduction rate was 95.45% in the hydrostatic reduction group and 86.20% in the pneumatic reduction group. Conclusion The new-type ultrasound-guided hydrostatic reduction has a higher reduction rate in the treatment of acute intussusception in children results in a shortened hospital stay, It is effective, safe, and avoids radiation exposure.

Developing a nomogram for predicting surgical intervention in pediatric intussusception after hydrostatic reduction

“…Both of the 2 non-surgery techniques can be performed safely and exhibits high success rates (6). Currently, ultrasound-guided hydrostatic reduction has been suggested as the first choice for intussusception treatment in several studies, because it has a higher success rate, shorter hospital stay and no radiation risk comparing to pneumatic reduction (6)(7)(8). When non-surgery treatment is contraindicated or has failed, surgery procedures will be conducted.…”

Air enema reduction versus hydrostatic enema reduction for intussusceptions in children: A systematic review and meta-analysis

“…Additionally, the use of warm saline aids in the expulsion of intestinal contents, reducing the absorption of toxins by the intestinal tract. This, in turn, mitigates complications in children following the enema reduction, ultimately leading to a shorter hospital stay [ 12 , 36 , 41 , 62 , 71 ].…”

“…A predetermined initial pressure is established, followed by ultrasound-guided injection of warm saline into the intestinal tract. Successful reduction is verified when saline flows into the intestinal tract from the ileocecal region, resulting in the manifestation of characteristic signs such as the “crab claw sign” and “honeycomb sign” [ 12 ]. Although numerous studies have indicated that UGHR has advantages such as a higher success rate of resetting, greater safety, and radiation-free procedures, these merits are considered worthy of implementation in clinical practice.…”

Predictive factors for failure of nonsurgical management of intussusception and its in-hospital recurrence in pediatric patients: a large retrospective single-center study

“…and mucus, known as "red currant jelly stools". Nevertheless, patients may present with nonspecific manifestations [3,5]. The prevailing site is the ileocolic region [6,7].…”

“…The treatment of choice is nonoperative, with surgical intervention reserved for failure in achieving reduction. There are different techniques for enema reduction, the most frequent are normal saline and air enema [1][2][3][4][5][6][7][8][9]. Various reports diverge on the best reduction approach.…”