Intussusception in Children

Minami, Akira

doi:10.1001/archpedi.1975.02120400050011

Cited by 20 publications

(7 citation statements)

References 9 publications

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“…Some authors in the past have recommended routine use of general anesthesia, including gas, 70 thiopenthal, 71 and ketamine, 72 which they believed improved enema reduction rate (level 4); however no differences have been demonstrated in reduction rates between two groups with and without anesthesia 73 (level 3b). On the contrary, in an animal experiment, pig groups in which straining (Valsalva maneuver) was lost under deep general anesthesia showed a higher colonic perforation rate by enema reduction when compared with the group in which straining was preserved by light anesthesia 74 (level 5).…”

Section: Treatmentmentioning

confidence: 99%

“…There is little evidence supporting the commonly taught “Rules of Threes” regarding the liquid enema technique, particularly in regards to the appropriate height of the enema bag. There are reports of more than three attempts, 70,109 or 5 min duration 70,72,75 (level 4); however, there is no doubt that radiation times should be kept to a minimum. Therefore, three attempts of 3 min duration is the ideal standard.…”

Section: Treatmentmentioning

confidence: 99%

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Japanese guidelines for the management of intussusception in children, 2011

Ito

Kusakawa

Murata

et al. 2012

Pediatrics International

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Background: The Japanese Society of Emergency Pediatrics has formulated evidence-based guidelines for the management of intussusception in children in order to diagnose intussusceptions promptly, to initiate appropriate treatment as early as possible, and to protect intussuscepted children from death. Methods: Literature was collected systematically via the Internet using the key words "intussusception" and "children."The evidence level of each paper was rated in accordance with the levels of evidence of the Oxford Center for Evidence-based Medicine. The guidelines consisted of 50 clinical questions and the answers. Grades of recommendation were added to the procedures recommended on the basis of the strength of evidence levels. Results: Three criteria of "diagnostic criteria," "severity assessment criteria," and "criteria for patient transfer" were proposed aiming at an early diagnosis, selection of appropriate treatment, and patient transfer for referral to a tertiary hospital in severe cases. Barium is no longer recommended for enema reduction (recommendation D) because the patient becomes severely ill once perforation occurs. Use of other contrast media, such as water-soluble iodinated contrast, normal saline, or air, is recommended under either fluoroscopic or sonographic guidance. Delayed repeat enema improves reduction success rate, and is recommended if the initial enema partially reduced the intussusception and if the patient condition is stable. Conclusions:The guidelines offer standards of management, but it is not necessarily the purpose of the guidelines to regulate clinical practices. One should judge each individual clinical situation in accordance with experiences, available devices, and the patient's condition.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Japanese guidelines for the management of intussusception in children, 2011

Ito

Kusakawa

Murata

et al. 2012

Pediatrics International

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“…Earlier contraindications to attempting primary hydrostatic reduction, such as elevated temperature and white blood cell count, older age, recurrent intussusception, and suspicion of an anatomic abnormality acting as a leading point, have since proved invalid [7][8][9][10][11][12][13]. There is no agreement, however, on the advisability of attempting hydrostatic reduction in intussusceptions considered possibly gangrenous and irreducible, such as those of long duration (over 24 or 48 hr) and especially those with evidence of small bowel obstruction (SBO) [9,[12][13][14][15].…”

Section: Althoughmentioning

confidence: 99%

“…There is no agreement, however, on the advisability of attempting hydrostatic reduction in intussusceptions considered possibly gangrenous and irreducible, such as those of long duration (over 24 or 48 hr) and especially those with evidence of small bowel obstruction (SBO) [9,[12][13][14][15]. Many authors, citing that such intussusceptions often prove reducible hydrostatically and that the attempt is essentially harmless, recommend this method of treatment for all patients with the exception of those in shock or with signs of peritonitis [7,8,10,11,16,17]; others consider longstanding symptoms and SBO contraindications to hydrostatic reduction attempts [9, 12-15, 18, 19], pointing out the danger of bowel perforation and barium peritonitis [18,20].…”

Section: Althoughmentioning

confidence: 99%

Treatment of intussusception with small bowel obstruction: application of decision analysis

Jc¹

1985

American Journal of Roentgenology

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“…Intussusception in adults is a relatively rare condition that is often caused by neoplastic disease [1]. Intussusception is a common condition in children, with > 90% of cases said to be idiopathic without any organic disease [2]. Approximately 10% of all intussusceptions have been reported in adults [3,4].…”

Section: Introductionmentioning

confidence: 99%

Intussusception caused by a small intestinal lipoma with ectopic gastric mucosa containing gastric cystica profunda component cells within the inverted Meckel’s diverticulum: a case report

et al. 2020

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Background Lipomas are the most common cause of intussusception in adults. To our knowledge, however, no cases of lipoma and ectopic gastric mucosa with gastritis cystica profunda (GCP) have been reported. We report a case of intussusception caused by a small intestinal lipoma with ectopic gastric mucosa containing GCP-component cells within the inverted Meckel’s diverticulum. Case presentation A female in her 40s underwent computed tomography for postoperative follow-up of left breast cancer. A tumor, suspected to be a lipoma, was found in the ileum. Since there were no symptoms, the patient underwent regular follow-up. However, gradual enlargement was observed, and surgery was recommended due to the risk of intussusception. After reduction via the Hutchinson technique, laparoscopically assisted partial resection of the small intestine was performed due to suspicion that the tumor was causing intussusception starting from the ileum. Histopathologic examinations revealed proliferation of mature adipose tissue in the subserosal layer, which was diagnosed as lipoma. Furthermore, adipose tissue was found in the stem area and accordingly, we diagnosed lipoma associated with the inverted Meckel’s diverticulum. Moreover, gastric mucosa-like crypt epithelium and proper glandular tissue were identified in the mucosal membrane at the area of onset, and signs of gastric pit dilatation over the submucosa and crypt epithelium hyperplasia were observed. Diagnosis was ectopic gastric mucosa containing GCP component tissue. Conclusions Intussusception in the small intestine complicated with lipoma and ectopic gastric mucosa with GCP within the Meckel’s diverticulum has not been reported, demonstrating the rarity of our case.

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Intussusception in Children

Cited by 20 publications

References 9 publications

Japanese guidelines for the management of intussusception in children, 2011

Japanese guidelines for the management of intussusception in children, 2011

Treatment of intussusception with small bowel obstruction: application of decision analysis

Intussusception caused by a small intestinal lipoma with ectopic gastric mucosa containing gastric cystica profunda component cells within the inverted Meckel’s diverticulum: a case report

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