Twenty years' experience for reduction of ileocolic intussusceptions by saline enema under sonography control

Flaum, Valérie; Schneider, Anne; Ferreira, Cindy Gomes; Philippe, Paul; Sancho, Consuelo Sebastia; Lacreuse, I.; Moog, R.; Kauffmann, I.; Koob, Mériam; Christmann, D.; Douzal, V.; Lefèbvre, François; Baudin, François

doi:10.1016/j.jpedsurg.2015.09.022

Cited by 77 publications

(62 citation statements)

References 16 publications

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“…In a similar study, Pazo et al evaluated 21 patients with intussusception and re-ported that successful reduction was achieved in the second attempt in 9 (43%) and in the third attempt in 4 (19%) patients (31). Conversely, Naidch et al reported that successful reduction was achieved in the second attempt in only 2 (13.6%) out of 17 patients (22). In addition, Fallon et al Flaum et al and Briton et al suggested that the success rates increased as the number of attempts increased (19,30).…”

Section: Discussionmentioning

confidence: 97%

Ultrasound Guided Reduction of Intussusception with Saline and Evaluating the Factors Affecting the Success of the Procedure

2018

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Background: Intussusception is a major cause of acute abdomen in childhood. Prompt diagnosis and appropriate treatment of intussusception is of prime importance for preventing morbidity and mortality. In this study, we aimed to investigate the effectivity of ultrasound (USG)-guided hydrostatic reduction of intussusception with saline and to investigate the factors affecting the success of this method. Methods: A total of 100 children with intussusception who were treated by hydrostatic reduction with saline were retrospectively reviewed. The effect of age, gender, duration of symptoms, rectal bleeding, number of reduction attempts performed, and the diameter and length of the invaginated segment measured on USG were evaluated. Results: Successful reduction was achieved in 88 (88%) patients. Mean age was 24.83 months, with 25.59 months in patients with successful reduction and 20 months in patients with failed reduction. Reduction was successful in 83.9% of the patients with a history of rectal bleeding and in 94.7% of the patients with no history of rectal bleeding (P > 0.05). Mean duration of symptoms was 2.74 days in the patients with successful reduction and 4.33 days in the patients with failed reduction. The mean diameter and length of the invaginated segments measured on USG were 3.5 cm and 5.12 cm in the patients with successful reduction and 4.27 cm and 9.23 cm in the patients with failed reduction, respectively. No significant difference was observed between the patients with successful and failed reduction in terms of rectal bleeding, vomiting, gender, age, and body weight (P > 0.05). It was also found that success rate increased as the number of reduction attempts increased and the success rate decreased as the duration of symptoms and the diameter and the length of the invaginated segment increased (P < 0.05). Conclusions:In conclusion, USG-guided reduction of intussusception with saline is a practical and safe method that yields high success rates. Repeating this method in patients with partial reduction that are clinically stable leads to a significant increase in the success of the procedure. A prolonged duration of symptoms and an increase in the size and the diameter of the invaginated segment may have adverse effects on the success of the procedure.

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Section: Discussionmentioning

confidence: 97%

Ultrasound Guided Reduction of Intussusception with Saline and Evaluating the Factors Affecting the Success of the Procedure

2018

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“…In Europe, sedation is used more frequently: a survey among pediatric radiologists reported routine use of sedation by 34.9% of respondents . One study describes a positive effect of sedation on success rate, reporting an odds ratio of 10 …”

Section: Introductionmentioning

confidence: 99%

Effects of esketamine sedation compared to morphine analgesia on hydrostatic reduction of intussusception: A case‐cohort comparison study

Bunt

Veldhoen

Nievelstein

et al. 2017

Pediatric Anesthesia

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“…Accordingly, this study aimed to perform POCUS by applying criteria set to broader standards in patients presenting any one of intermittent abdominal pain/irritability or bloody stool, or at least two symptoms among nonspecific abdominal pain/irritability, abdominal mass/distension, vomiting, or lethargy. Consequently, the enrolled patients with intussusception were considered to be in the early stage, which presented symptoms for a much shorter mean duration of 11.7 hours instead of a duration of over 18.5 hours reported in previous studies [14][15][16]. The favorable treatment outcome in 97.1% of patients with successful air enema reduction also indirectly indicates that the patients were in early stages of intussusception; only 2 patients required surgical reduction.…”

Section: Discussionmentioning

confidence: 99%

Point-of-Care Ultrasound May Be Useful for Detecting Pediatric Intussusception at an Early Stage

Lee

Kim

Choi

et al. 2020

Preprint

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Background: This study aimed to verify the usefulness of point-of-care ultrasound (POCUS) performed by pediatric emergency physicians for detecting intussusception at an early stage.Methods: This retrospective study included 1-month-to 6-year-old children with clinically suspected intussusception, who underwent POCUS in the pediatric emergency department between December 2016 and February 2018. The criteria for performing POCUS were set to broader standards: presenting any one of intermittent abdominal pain/irritability or bloody stool, or ≥2 symptoms among nonspecific abdominal pain/irritability, abdominal mass/distension, vomiting, or lethargy. POCUS results were interpreted and categorized as "negative" or "suspicious," and a radiologist performed confirmatory ultrasound in "suspicious" cases.Results: We analyzed 575 POCUS scans from 549 patients (mean age, 25.5 months). Among the 92 "suspicious" cases (16.0%), 70 (12.2%) were confirmed to have intussusception. POCUS showed 100% sensitivity, 95.6% specificity, and 97.8% accuracy. Patients with confirmed intussusception were mainly diagnosed in the early stages, with a mean symptom duration of 11.7 hours, and most patients (97.1%) were treated successfully via air enema reduction. Compared to the nonintussusception group, the intussusception group had more intermittent abdominal pain ( P < 0.001), but less vomiting ( P = 0.001); the other clinical features showed no intergroup differences.Conclusion: POCUS performed using the criteria set to broader standards by pediatric emergency physicians may be useful for detecting intussusception at an early stage, which may present with obscure clinical symptoms. POCUS:Point-of-care ultrasound RADUS: Radiologist-performed ultrasound Declarations Ethics approval and consent to participate: The institutional review board of Asan Medical Center approved this study and waived the requirement for informed consent (study number 2018-0418).

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Twenty years' experience for reduction of ileocolic intussusceptions by saline enema under sonography control

Cited by 77 publications

References 16 publications

Ultrasound Guided Reduction of Intussusception with Saline and Evaluating the Factors Affecting the Success of the Procedure

Ultrasound Guided Reduction of Intussusception with Saline and Evaluating the Factors Affecting the Success of the Procedure

Effects of esketamine sedation compared to morphine analgesia on hydrostatic reduction of intussusception: A case‐cohort comparison study

Point-of-Care Ultrasound May Be Useful for Detecting Pediatric Intussusception at an Early Stage

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