Ultrasound‐guided hydrostatic enema reduction of intussusception and confirmation with single abdominal radiograph in children

Abstract

Purpose To detect false‐positive reduction results after ultrasound (US)‐guided hydrostatic intussusception reduction, we have incorporated water‐soluble contrast material to the enema fluid and confirmed the reduction with a single abdominal radiograph. We present the results of the combined imaging method for the reduction of intussusception in children. Materials and Methods The records of the patients who were treated for intussusception were analyzed retrospectively. Patients were divided into two groups: a US‐guided reduction group and a US‐guided reduction plus radiographic control group. The patient characteristics, symptoms, treatment methods, outcomes, and complications and follow‐up were analyzed. Results A total of 164 intussusception episodes were treated in 153 patients. Hydrostatic reduction of intussusception was performed in 59 patients in the US‐guided group and in 94 patients in the US‐guided plus radiographic control group. Recurrence rate in the US‐guided group was 15.7%, vs 3.5% in the US‐guided plus radiography group (P = .029). In the US‐guided plus radiographic control group, 5 (5.3%) false positive reductions under US guidance were determined by abdominal radiography. Conclusion In order to decrease false positive reduction rate and early recurrence, US‐guided intussusception reduction can be performed with saline plus water‐soluble contrast material and confirmation of reduction obtained with a single direct abdominal radiograph.

Predictive factors for failure of nonsurgical management of intussusception and its in-hospital recurrence in pediatric patients: a large retrospective single-center study

“…Our analysis looked into early recurrences with varying time spans from 1 to 3 days. A study by Karakus et al [19], which inquired into early recurrences, up to 48 h, obtained a rate of 15.7%, which is similar to ours. Hence, we believe that early recurrences identified following hydrostatic reduction of intussusception under US guidance may likely represent insufficient or "false-positive" reductions.…”