Multimodalities of Management of Paediatric Ileocolic Intussusception

Abstract

Intussusception is a life-threatening illness and occurs when a portion of the intestine folds like a telescope with one segment slipping inside another segment. Hirschsprung was the first to publish a series of reports on successful hydrostatic reduction in 1876. Intussusception remains one of the most commonly encountered paediatric surgical emergencies. Enema reduction still remains the mainstay of non-operative care today. Barium and more recently air contrast enemas have been the initial diagnostic and therapeutic investigation of choice. Successful reduction rates vary widely from 42 to 95% (eee). AIMS AND OBJECTIVES: Aims and objectives of this article with a series of cases of intussusception is to review the various clinical presentation and to study the effectiveness of non-surgical intervention using contrast or AIR enema reduction under fluoroscopic guidance. METHODS AND RESULTS: A prospective study from October 2010 to September 2015 was carried out in hospitals in Bangalore. Complete review of medical records for clinical and demographic information was only performed for those cases fulfilling diagnostic criteria. During the study, A total of 62 patients diagnosed cases were included in this study. Cases identified in the study were similar in presentation and demographics as those observed in other South Asian Countries. These patients were haemodynamically stabilized and were subjected to definitive procedure; enema reduction was tried in all patients. Multimodalities of management included nonoperative reduction that is hydrostatic enema reduction in 2 cases (3.2), barium enema reduction 45 cases (72.5) and air enema recution in 12 cases (19.3), finally 3 cases (4.8) which failed enema reduction were operated. One case (1.61) intussusception -associated death was recorded. CONCLUSION: Surgical intervention in intussusception can be prevented by nonoperative reduction, especially if presented early and no signs of peritonitis.