Intussusception: trapped peritoneal fluid detected with US--relationship to reducibility and ischemia.

del-Pozo, Gloria; González-Spínola, J.; Gómez‐Anson, Beatriz; Serrano, C. Sancho; Miralles, Manuel Lucas; González-deOrbe, G; Cano, I; Martínez, Alicia Martín

doi:10.1148/radiology.201.2.8888227

Cited by 84 publications

(44 citation statements)

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“…25,29 For example, del-Pozo et al 29 reported that entrapped fluid was present in 14% of their cases of intussusception and that, among those cases, the success rate for sonographically guided pneumatic reduction was only 26%. Britton and Wilkinson 25 reported the presence of entrapped fluid in 12% of their cases and a success rate of only 14% and concluded that this factor is a consistent indicator of poor outcome of pneumatic reduction.…”

Section: Discussionmentioning

confidence: 99%

“…In our series, entrapped fluid was present in a similar proportion of cases (11%), but our rate of successful reduction was much higher (64%) than the rates in the previous series. 25,29 We assume that the ability of sonographically guided hydrostatic enema to allow constant realtime monitoring of the relationship between the intussusceptum and the intussuscipiens and to permit meticulous control of the enema fluid explain why this method was consistently effective and safe, even in cases in which initial diagnostic sonography revealed the presence of risk factors. Because of these advantages, we believe that sonographically guided hydrostatic enema is superior to other methods of reduction, especially in potentially difficult cases.…”

Section: Discussionmentioning

confidence: 99%

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Sonographically guided hydrostatic reduction of intussusception in children

Crystal

Hertzanu

Farber

et al. 2002

J of Clinical Ultrasound

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Sonographically guided hydrostatic reduction of intussusception is safe and effective. We recommend that this method be attempted before surgery is considered, even in cases in which the intussusception contains entrapped fluid or is located in the left side of the abdomen. The level of experience of the radiologist who performs the reduction significantly affects the results of this procedure and should be carefully considered, particularly in cases in which initial sonography reveals the presence of risk factors.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sonographically guided hydrostatic reduction of intussusception in children

Crystal

Hertzanu

Farber

et al. 2002

J of Clinical Ultrasound

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“…A correct execution of US examination also requires a careful search for abdominal fluid, as free peritoneal fluid or localized near interested bowels, also known as the ''trapped-fluid sign'', caused by trapped fluid between the serosal surfaces of intussuscepted loops [17]. As also reported by Literature, the identification of free endo-peritoneal fluid does not necessarily indicate the presence of complications such as peritonitis or perforations, while the occurence of fluid ''trapped'' between intussuscepted bowel segments, that can be observed in less than 15 % of cases, seems to correlate with a lower reduction rate [17,24] and has been described as a highly predictive sign of bowel necrosis [18]. In our study we found the presence of free endo-abdominal fluid in five patients, all of these submitted to surgery.…”

Section: Discussionmentioning

confidence: 86%

Intussusception in childhood: role of sonography on diagnosis and treatment

Bartocci¹,

Fabrizi²,

Valente³

et al. 2014

J Ultrasound

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Objective The aim of this study was to determine the role of ultrasound in the diagnosis and treatment of pediatric patients with acute abdominal pain caused by intussusceptions. Materials and methods We performed a retrospective study of all pediatric patients with acute abdominal pain caused by intussusceptions and that underwent ultrasound examination at the emergency service of the Radiology Department between November 2007 and June 2013. The role of ultrasonography in the diagnosis of intussusceptions has been assessed by comparing the echographic presumptive diagnosis with the final diagnosis of discharge. Its importance in the treatment has been assessed by determining the value of ultrasound findings in the choice of the best treatment. Results The ultrasound examination was positive in 16/18 patients with a final diagnosis of intussusception. Some sonographic findings seemed to be able to predict the opportunity to resort to non-surgical therapeutic options like hydrostatic or pneumatic reduction of the intestinal segments invaginated. In our casuistry, five children presented characteristics typical of this subgroup and underwent barium enema which provided the reduction of the intestinal segments involved. The future challenge will be to perform non-surgical ultrasound-guided reductions to avoid the exposure of the infants to ionizing radiations. Conclusions Ultrasonography is essential not only in the diagnosis, but also it adds important elements in the therapeutic choice and could play in the future an important role in non-surgical reduction of intestinal intussusceptions in pediatric patients.Keywords Intussusception Á Childhood Á Sonography Riassunto Obiettivo Accertare il ruolo dell'ecografia nella diagnosi e trattamento dei pazienti pediatrici con dolore addominale acuto causato da invaginazione intestinale. Materiali e metodi Abbiamo eseguito uno studio retrospettivo su tutti i pazienti pediatrici con dolore addominale acuto causato da intussuscezione e sottoposti ad esame ecografico presso il servizio di emergenza del Dipartimento di Radiologia tra il Novembre 2007 ed il Giugno 2013. Il ruolo dell'ecografia nella diagnosi di intussuscezione è stato valutato comparando la diagnosi presuntiva ecografica con la diagnosi finale di dimissione; per ciò che concerne la sua importanza nel trattamento, ci si è basati sull'influenza dei reperti ecografici sul percorso terapeutico. Risultati Su 18 pazienti con diagnosi finale di intussuscezione l'esame ecografico è risultato positivo in 16 casi; inoltre è stato possibile osservare che alcuni reperti ecografici sembrano essere in grado di predire l'opportunità di ricorrere ad opzioni terapeutiche non chirurgiche, vale a dire riduzione idrostatica o pneumatica del segmento intestinale invaginato. Nella nostra casistica, 5 bambini hanno presentato caratteristiche tali da rientrare in questo sottogruppo, e pertanto sono stati sottoposti a clisma opaco, 123J Ultrasound (2015( ) 18:205-211 DOI 10.1007 tramite cui in 3 casi si è ottenuto lo svaginam...

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“…We consider this appropriate because studies have shown that although the probability of reduction falls with longstanding intussusception, a successful reduction is still possible [23][24][25][26][27]. Research has also shown that although likelihood of success with free or trapped fluid is relatively low, success is still possible [28,29], and the vast majority (86%) of our respondents said they attempt reduction despite the presence of free fluid. Similarly, reduction is less likely but still possible if decreased blood flow is demonstrated by Doppler US [30], and 82% of our respondents perform the procedure despite decreased blood flow (similar to a previous study) [19].…”

Section: Discussionmentioning

confidence: 94%