Skip to main content
Log in

Ultrasound guided hydrostatic reduction of intussusception in children by saline enema: our experience

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Intussusception is a common cause of acute intestinal obstruction with potentially serious complications. The treatment of choice is an attempt at initial non-operative treatment.

Aim

The purpose of the study was to evaluate the efficacy of the technique of hydrostatic reduction of intussusception using saline enema and ultrasound being practiced in our institute; the secondary goal was to identify patient subset in which it is more successful.

Material and Methods

The case records of all patients treated for intussusception in our institute from 1st January 2000 to 30th June 2007 were retrospectively analyzed to collect information. All patients with ultrasound diagnosed intussusception that were not having signs of shock or peritonitis were treated with normal saline enema under ultrasound guidance. Failure of three such attempts was an indication for operation.

Result and Conclusions

We found that this technique is easy, safe and extremely effective in treating intussusception in children. The success rate was 81.37% (83 out of 102 cases) and mortality rate was 1.2%. Ileoileocolic type of intussusception failed enema reduction more often (statistically significant; P value = 0.0032) while older patients (statistically significant, P value = 0.001) had higher success rates with the technique. Patients who had colocolic type of intussusception (P value = 0.29) and patients who present early (P value = 0.262) appear to have higher success rates but this was not statistically significant.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Huppertz HI, Gabarro MS, Grimprel E, Franco E, Mezner J, Desselberger U et al (2006) Intussusception among young children in Europe. Pediatr Infect Dis J 25:S22–S29

    Article  PubMed  Google Scholar 

  2. Gangopadhyay AN, Wardhan H (1989) Intestinal obstruction in Children in India. Pediatr Surg Int 4(2):84–87

    Article  Google Scholar 

  3. Frush DP, Zheng JY, McDermott VG, Bisset GS (1995) Non-operative treatment of intussusception: Historical perspective. Am J Roentgenol 165:1066–1070

    CAS  Google Scholar 

  4. Ravitch, Mark M.; Morgan, Russell H (1952) Reduction of Intussusception by Barium Enema. Ann Surg 135 (5):596–604

    Article  PubMed  CAS  Google Scholar 

  5. Krishnakumar, Hameed S, Umamaheshwari (2006) Ultrasound guided hydrostatic reduction in the management of intussusception. Indian J Pediatr 73:217–220

    Article  PubMed  CAS  Google Scholar 

  6. Henry PY, Hariharan S, Joseph J (2000) Childhood intussusception-Saline hydrostatic reduction under ultrasound guidance: a prospective study. J Indian Assoc Pediatr Surg; vol-5,issue-2, p 51–57

    Google Scholar 

  7. Sarin YK, Rao JS, Stephen E (1999) Ultrasound guided water enema for hydrostatic reduction of childhood intussusception-a preliminary experience. Indian J Radiol Imaging 9:59–63

    Google Scholar 

  8. Abdulrahman A, Al-Bassam, Orfale N (1995) Intussusception in infants and children: a review of 60 cases. Ann Saudi Med 15(3):205–208

    Google Scholar 

  9. Alamdaran SA, Zandi B, Sadeghipor S, Esfandiari H (2006) Ultrasound guided hydrostatic reduction of childhood intussusceptions using water enema. Iran J Med Sci 31(4):224–227

    Google Scholar 

  10. Bai YZ, Qu RB, Wang GD, Zhang KR, Li Y, Huang Y et al (2006) Ultrasound guided hydrostatic reduction by saline enema; a review of 5228 cases in 17 years. Am J Surg 192(3):273–275

    Article  PubMed  Google Scholar 

  11. Wang GD, Liu SJ (1988) Enema reduction of intrussusception by hydrostatic reduction under ultrasound guidance. J Pediatr Surg 23(9):814–818

    Article  PubMed  CAS  Google Scholar 

  12. Peh WC, Khong PL, Chan KL, Lam C, Cheng W, Lam WW et al (1996) Sonographically guided hydrostatic reduction of childhood intussusception using Hartmann’s solution. Am J Roentgenol 167 (5):1237–1241

    CAS  Google Scholar 

  13. Wood SK, Kim JS, Suh SJ, Paik TW, Choi SO (1992) Chilhood intussusception: ultrasound guided hydrostatic reduction. Radiology 182(1):77–80

    PubMed  CAS  Google Scholar 

  14. Pendergast L, Wilson M (2003) Intussusception: A Sonographer’s Perspective. J Diagn Med Sonography 19(4):231

    Article  Google Scholar 

  15. Fiorito ES, Cuestas LAR (1959) Diagnosis and treatment of acute intestinal intussusception with controlled insufflation of air. Pediatrics; vol-24,2; Aug: 1959, pp 241–244

    PubMed  CAS  Google Scholar 

  16. del-Pozo G, Albillos JC, Tejedor D, Calero R, Rasero M, dela-Calle U et al. (1999) Intussusception in Children: Current concepts in diagnosis and enema reduction. Radiographics 19:299–319

    PubMed  CAS  Google Scholar 

  17. Markowitz RI, Meyer JS (1992) Pneumatic versus hydrostatic reduction of intussusception. Radiology 183:623–624

    PubMed  CAS  Google Scholar 

  18. Joseph J, Palliyil MM. Non-surgical management for intussusception in infants and young children. (Protocol) Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD006476. DOI: 10.1002/14651858.CD006476

  19. Tellado MG, Liras J, Mendez R, Somoza I, Sanchez A, Mate A et al (2003) Ultrasound guided Hydrostatic reduction for the treatment of idiopathic intestinal invagination. Cir Pediatr 16(4): 166–168

    PubMed  CAS  Google Scholar 

  20. Mallol MJ, Cruz JMR, Hortiguela MEM, Perez JB, Corominas IC (1993) Acute intestinal invagination: Hydrostatic reduction Vs Pneumatic reduction. An Esp Pediatr 38 (1):17–19

    Google Scholar 

  21. Shiels WE, Maves CK, Hedlund GL, Kirks DR (1991) Air enema for diagnosis and reduction of intussusception: clinical experience and pressure correlates. Radiology 181:169–172

    PubMed  Google Scholar 

  22. van den Ende ED, Allema JH, Hazebroek FW, Breslau PJ (2005) Success with hydrostatic reduction of Intussusception in relation to duration of symptoms. Arch Dis Child 90 (10):1071–1072

    Article  PubMed  Google Scholar 

  23. Eklof OA, Johanson L, Lohr G (1980) Childhood intussusception: hydrostatic reducibility and incidence of leading points in different age groups. Pediatr Radiol 10 (2):83–86

    Article  PubMed  CAS  Google Scholar 

  24. Lanocita M, Castiglioni (1980) Use of glucagons in the reduction of intussusception; Presentation of one case. Radiol Med (Torino) 66(7–8):513–516

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Debashish Nayak.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nayak, D., Jagdish, S. Ultrasound guided hydrostatic reduction of intussusception in children by saline enema: our experience. Indian J Surg 70, 8–13 (2008). https://doi.org/10.1007/s12262-008-0002-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-008-0002-3

Keywords

Navigation