Indications for laparotomy after hydrostatic reduction for intussusception

Pierro, Agostino; Donnell, S.C.; Paraskevopoulou, C.; Carty, Helen; Lloyd, David T.

doi:10.1016/0022-3468(93)90153-c

Cited by 19 publications

(10 citation statements)

References 11 publications

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“…The total incidence of recurrent intussusception in the present study of 278 children treated by three different procedures was 4%, which was comparable to that documented [6][7][8][9]. It was suggested that ileopexy and segmental resection could reduce the recurrence, but their effectiveness was not well evaluated.…”

Section: Discussionsupporting

confidence: 79%

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Recurrent ileocolic intussusception after different surgical procedures in children

et al. 2006

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Intussusception in children may recur after surgical correction. Ileopexy has popularly been used as a procedure to prevent recurrent intussusception, but its effect has not been well evaluated. The present study compared the incidence of recurrent intussusception after several different surgical procedures for intussusception in children. The charts of 278 children undergoing surgical reduction of ileocolic intussusception over 17 years were retrospectively reviewed. The incidence of recurrent intussusception was compared among the three surgical procedures: simple manual reduction, manual reduction plus ileopexy, and segmental resection. Simple manual reduction was performed in 67 (24.1%) of the 278 patients, manual reduction plus ileopexy in 186 (66.9%), and resection of the involved segment in 25 (9.0%). There were four episodes of recurrence in three (4%) patients who had had manual reduction, nine episodes in eight (4%) patients who had undergone ileopexy, and none after segmental resection. There was no statistical difference in recurrent rate among the three groups (reduction vs. ileopexy, P = 0.95; reduction vs. resection, P = 0.28; ileopexy vs. resection, P = 0.29). Ileopexy is not better than simple manual reduction in preventing recurrence of ileocolic intussusception in children.

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Section: Discussionsupporting

confidence: 79%

“…Successful reduction can often be achieved with barium, saline, or gas enemas [3], but 10-30% of patients require surgical correction [4,5]. The documented incidence of recurrence after surgical correction of idiopathic intussuception in children varied between 0 and 5.4% [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Recurrent ileocolic intussusception after different surgical procedures in children

et al. 2006

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“…The incidence of intussusception in less than three months and above six years of age is rare. [13][14][15][16][17][18] The same was observed in our series as over 80% of the patients were younger than 2 years.…”

Section: Discussionsupporting

confidence: 76%

Single-center experience of managing childhood intussusception

Uddin¹,

Gupta²,

Jabir³

et al. 2021

J Pediatr Adolesc Surg

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Background: Intussusception is one of the emergencies encountered in early childhood requiring emergent interventions. The purpose of the study is to determine the outcomes and prognosis of our methods and management strategies employed in children who developed intussusception. Methods: This is a retrospective case series performed by reviewing the patient medical records, sonographic and radiological reports, and surgical notes of the patients managed for intussusception at our hospital from 2009–2018. Results: A total of 355 cases of intussusception were managed during the study tenure. The etiology was idiopathic in 97.4% whereas the remaining patients had Meckel’s diverticulum, lymphoma, and intestinal polyp as pathological lead point (PLP). Ultrasound was used for the diagnosis as the primary investigation tool in all the patients, with 100% diagnostic accuracy in the current study. Non-operative management by hydrostatic reduction was performed successfully in 79.43% of the patients. Total episodes with recurrence were 23 (6%); 30% had recurrence within 48 hours. Recurrence occurred by an average of 7.68 months after the successful reduction. Conclusions: The majority has idiopathic etiology, but secondary cause with some pathological lead point is also not uncommon. Profound attention is required for prompt identification and treatment to avoid bowel ischemia. Ultrasound remains the preferred diagnostic modality in our patients. Even with recurring episodes of intussusception, the primary treatment remains hydrostatic reduction.

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“…Many cases have been diagnosed as filling defects or polypoid tumors of cecum and absence of appendiceal filling [4][5][6]. Although a similar observation was made in the present case, the filling defect has been considered to result from cecal edema in the first place after a report by Pierro et al indicating frequent detection of such an observation [9]. However, persistent or fast recurrent intussusceptions are likely to be associated with an increased appendiceal abnormality, justifying a laparotomy in the present case [5].…”

Section: Discussionsupporting

confidence: 55%