Risk factors for surgery in pediatric intussusception in the era of pneumatic reduction

A review of intussusception cases involving failed pneumatic reduction and re-intussusception

“…It has been determined by a majority of authors that the factors increasing the probability of surgical intervention were use of hydrostatic enema, failure of the first attempt at enema reduction, bloody stools, symptoms that had lasted more than 24-48 hours, age younger than 1 year, and a long length of intussuscepted bowel. [1,10] In the present series, the rate of unsuccessful reduction was 5%, and 75% of those patients were younger than 1 year of age. However, this was not found to be statistically significant.…”

“…Hydrostatic and pneumatic reductions have been compared in numerous studies, and higher rates of success and lower mortality rates have been reported with the use of pneumatic reductions. [1][2][3][4] The success rate of PR was found to be 88-95%. [3,5] The pneumatic method has other advantages, as well.…”

“…In the present study, it was particularly noteworthy that free intraabdominal fluid was found on USG in 80% of cases that included perforation. [1,5,12] No correlation of USG signs of intraabdominal fluid and perforation were presently determined.…”

“…Ultrasonography (USG) is the method most commonly used to diagnose intussusception. [1] Treatment options include enema reduction when appropriate, and should nonoperative methods prove unsuccessful, surgical intervention. Recently, the most commonly used method of treatment has been fluoroscopic or USG-guided pneumatic reduction (PR).…”

Pediatrik Abdomende Kontrastli Radyografi

“…Perforasyon riski direk olarak uygulanan basınç ile doğru orantılıdır. Ayrı-ca perforasyon açısından yüksek riskli kabul edilen durumlar; hasta yaşının 3 aydan küçük veya 5 yaştan büyük olması, bulguların 72 saatten uzun süredir olması, hematokezya, ciddi dehidratasyon, ince bağırsak obstrüksiyonudur [22][23][24][25][26]. Uzun yıllardır etkili tedavi yöntemi olarak kullanılan baryumlu kolon tetkiki perfo-rasyon durumunda kimyasal peritonit yapması nedeniyle artık yerini suda çözünen kontrast maddelere bırakmıştır.…”