Perforation of the intussuscepted colon

Humphry, A.; Ein, S. H.; Mok, P. M.

doi:10.2214/ajr.137.6.1135

Cited by 41 publications

(15 citation statements)

References 5 publications

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“…[1] At our institution, a paediatric surgical team performs hydrostatic reduction (HR) according to a standardised protocol with excellent results. [2,3] However, colocolonic intussusception (CI) is an uncommon cause of intestinal obstruction in children and because it is sometimes not easily diagnosed, [4,5] treatment can be delayed, resulting in more radical surgical intervention, such as a bowel resection, [6] being required.…”

Section: Introductionmentioning

confidence: 99%

A child with colo-colonic intussusception due to a large colonic polyp: Case report and literature review

Takahashi

Miyano

Kayano

et al. 2014

Afr J Paediatr Surg

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Section: Introductionmentioning

confidence: 99%

A child with colo-colonic intussusception due to a large colonic polyp: Case report and literature review

Takahashi

Miyano

Kayano

et al. 2014

Afr J Paediatr Surg

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“…The incidence of perforation during reduction has been reported to range from 0 to 5.9% [6], and there is increased risk for perforation and lower success rate (20%) if patients are less than 3 months old [14,15]. In our series, perforation during HR occurred in four cases who were 3, 10, 4, and 4 months of age, respectively, and symptoms continued for longer than 36 h in all except one patient.…”

Section: Discussionmentioning

confidence: 58%

Reduction of intussusception in infants by a pediatric surgical team: improvement in safety and outcome

et al. 2006

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Commonly, reduction of intussusception is performed by experienced radiologists. We review the performance of a pediatric surgical team for treating intussusception according to a standard protocol and present our findings. Three hundred and seventy eight patients with signs and symptoms of intussusception we treated from 1980 to 2005 were reviewed. Hydrostatic reduction (HR) was performed using a water-soluble contrast agent under fluoroscopy unless there was a serious condition clinically. Before 1998, HR was performed exclusively by pediatric surgical trainees (period A). In 1998, a standard protocol (double-balloon tube, maximum pressure of 120 cm H2O, repeated a maximum of five times, and HR performed by a pediatric surgical trainee under the supervision of a consultant pediatric surgeon) was adopted (period B). As part of the protocol, the operating room was notified of the HR procedure and placed on call for emergency surgery. Of the 378 patients, 21 required immediate laparotomy due to serious general condition, leaving 138 during period A and 219 during period B who had HR. Patient age, sex, and duration of symptoms (period A, 14.5 +/- 7.8 h; period B, 13.1 +/- 9.9 h) were not statistically significant. Success of HR during period A was 64.5%, and significantly improved for period B at 94.5% (P < 0.01). During period B, 128 of our patients had been referred from elsewhere for failed reduction attempted by radiologists or pediatricians. We were able to perform HR successfully in 118 of these (92.2%). During period A, it was significantly less at 54.0% (P < 0.01). Bowel perforation during HR occurred in two patients during period A (1.4%) and two patients during period B (0.9%), but the latter cases were transferred immediately for emergency surgery with good outcome. Reduction of intussusception by a pediatric surgical team would appear to be significantly safer with better outcome, and is thus more efficient.

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“…In patients below 6 months of age we were particularly careful, as in the past perforation has been reported to occur in patients of this age group (3,13).…”

Section: Discussionmentioning

confidence: 99%

Hydrostatic Reduction of Childhood Intussusception

Mortensson¹,

Eklöfn²,

Laurin³

1984

Acta Radiologica. Diagnosis

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The value of glucagon to facilitate hydrostatic reduction of childhood ileo-colic intussusception was tested in a series of 188 consecutive cases. Sixty-nine patients selected at random received 0.05 mg glucagon/kg body weight intramuscularly before attempts at reduction were started. The rate of successfully accomplished reductions was 84 per cent in the test group and 76 per cent in the control group (not significant). The time for accomplished reduction was approximately equal in the two groups. After 3 unsuccessful attempts at hydrostatic reduction patients in the control group received glucagon. The subsequent attempt at reduction proved successful in slightly more than every second case. No complications occurred. In general, glucagon was not found to improve the rate of employed reductions nor on the time necessary for reduction to take place. The investigation indicated, however, that there may be a limited benefit of adjuvant medication of glucagon. After two unsuccessful barium enemas glucagon administration is therefore recommended before a third attempt at reduction is performed.

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Perforation of the intussuscepted colon

Cited by 41 publications

References 5 publications

A child with colo-colonic intussusception due to a large colonic polyp: Case report and literature review

A child with colo-colonic intussusception due to a large colonic polyp: Case report and literature review

Reduction of intussusception in infants by a pediatric surgical team: improvement in safety and outcome

Hydrostatic Reduction of Childhood Intussusception

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