Indications for repeated enema reduction of intussusception in children

Vujović, Dragana; Lukač, Marija; Sretenović, Aleksandar; Krstajic, Tamara; Ljubic, Vesna; Sindjic-Antunovic, Sanja

doi:10.2298/sarh1406320v

Cited by 15 publications

(12 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our study, 8 patients who presented with symptoms since 6-12 h showed an 87.5% success rate, 26 patients who presented with symptoms since 12-24 h showed a 92.3% success rate, and patients who presented with symptoms more than 24 h showed 50% success rate. This is statistically significant and means that symptoms which started more than 24 h have a 50% failure rate; this finding is in agreement with Vujovic et al [9]. But this proves that even patients with a longer time of symptoms have a 50% success rate as long as they are vitally stable with no signs of peritonitis.…”

Section: Discussionsupporting

confidence: 89%

The efficacy of delayed, repeated reduction enema in management of intussusception

2021

View full text Add to dashboard Cite

Background Management of intussusception varies according to the case, time of presentation, cause, and symptoms. In this study, we focus on describing the demographic and sonographic characteristics of children with intussusception with failed initial enema reduction who were managed by delayed repeated enema attempts and identify predictors associated with successful repeated reduction. Results This study was conducted in the period from December 2018 to April 2020 at university hospitals (pediatric surgery unit). This study included 40 patients with intussusceptions; 27 are males, and 13 of them are females. Their ages ranged from 5 months to 3 years old. Patients in this study had failed initial enema reduction attempts under sonographic guidance and had subsequent delayed (≥ 2 h from the initial attempt) repeated enemas made up the study population. Of the 40 patients, 34 patients (85%) were successfully reduced, and 6 patients (15%) failed reduction and required surgical intervention. There were no deaths, perforation, or resection of gangrenous bowel. Two cases showed recurrences, but required no surgical intervention. It is also noted that early presentation (< 12 h), stable, non-complicated, and with little or no bloody diarrhea are predictors of successful DRE. Conclusion Delayed repeated enema in the treatment of intussusception is a viable option in patients with unsuccessful initial enema reduction provided that early presentation, stable vitals, and no signs of perforation or peritonitis are present.

show abstract

Section: Discussionsupporting

confidence: 89%

The efficacy of delayed, repeated reduction enema in management of intussusception

2021

View full text Add to dashboard Cite

show abstract

“…Intussusception is a common cause of children requiring admission to the emergency department and can lead to bowel obstruction. Intussusception occurs when a segment of the bowel invaginates into an immediately adjacent segment, often likened to a telescope, resulting in obstruction of the bowel, ischemia, and necrosis [ 1 , 2 ]. Five types of intussusceptions are described: ileo-colic, ileo-ileo-colic, jejuno-jejunal, jejuno-ileal, and colo-colic.…”

Section: Introductionmentioning

confidence: 99%

Ultrasonography for the Diagnosis of Intussusception in Children: An Experience From Pakistan

Dadlani

Lal

Shahani

et al. 2020

Cureus

View full text Add to dashboard Cite

Introduction: Intussusception can lead to small bowel obstruction in children, hence the early diagnosis of this condition is very important. The purpose of this study is to evaluate the accuracy of sonography in the diagnostic work-up of children with suspected intussusceptions in the emergency setting, keeping surgical findings as the gold standard. Methods and design: Two hundred patients with classical presentation of intussusceptions, who were diagnosed either by barium enema or CT scan, were included in this study. Patients with irreducible intussusceptions on color Doppler were followed after surgery. Results: The average age of the patients was 6.7 ± 2.8 years, and the study population consisted of 115 (57.5%) boys and 85 (42.5%) girls. One hundred forty-three patients were confirmed to have intussusception on ultrasonography, of whom 117 (81.8%) were confirmed to have intussusception after surgery while 26 (18%) were not diagnosed with intussusception during surgery. Despite the clinical presentation of intussusceptions, ultrasonography was not diagnostic in 57 patients, of whom 28 were confirmed to have intussusception after surgery and 29 were not found to have the disease. Conclusion: Use of ultrasonography in cases with intussusception has proven to be a reliable and accurate method for diagnosing intussusception and provides an advantage over unnecessary radiological or surgical procedures being performed.

show abstract

“…The first suggests that often, the illness is preceded by an upper respiratory infection, the second that the ileocolic region has the highest concentration of lymph nodes in the mesentery, and the third that enlarged lymph nodes are often observed in patients who require surgery. Whether the enlarged Peyer patch is a reaction to the intussusception or the cause of it is unclear (18). Rare causes include polyps, submucosal lipomas, Meckel's diverticulum and duplication cysts.…”

Section: Discussionmentioning

confidence: 99%

“…Ischemic mucosa sloughs off, leading to the heme-positive stools and subsequently to the classic "currant jelly stool" (a mixture of sloughed mucosa, blood, and mucus). If untreated, transmural gangrene and perforation of the leading edge of the intussusceptum occur (18).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided reduction of ileocolic intussusception in children

2016

View full text Add to dashboard Cite

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%.

show abstract

Indications for repeated enema reduction of intussusception in children

Abstract: The accuracy of ultrasound guided saline enema in intussusception reduction is high. Delay in presentation decreases success of non-operative treatment. Delayed enema reduction is important therapeutic option for intussusceptions. Surgical treatment is indicated in cases of complications.

Cited by 15 publications

References 21 publications

The efficacy of delayed, repeated reduction enema in management of intussusception

The efficacy of delayed, repeated reduction enema in management of intussusception

Ultrasonography for the Diagnosis of Intussusception in Children: An Experience From Pakistan

Ultrasound-guided reduction of ileocolic intussusception in children

Contact Info

Product

Resources

About