Pediatric Surgery International

, 25:977

Radiographic signs predictive of success of hydrostatic reduction of intussusception

  • Toshiaki Takahashi
  • Tadaharu Okazaki
  • Hiroko Watayo
  • Yuki Ogasawara
  • Nana Nakazawa
  • Yoshifumi Kato
  • Geoffrey J. Lane
  • Atsuyuki Yamataka
Original Article

DOI: 10.1007/s00383-009-2464-1

Cite this article as:
Takahashi, T., Okazaki, T., Watayo, H. et al. Pediatr Surg Int (2009) 25: 977. doi:10.1007/s00383-009-2464-1

Abstract

Aim

Outcome of hydrostatic reduction of intussusception (HRI) was analyzed according to specific radiographic signs to improve success.

Methods

At our institution, a pediatric surgical team performs HRI using a standardized protocol. We reviewed 266 consecutive HRI performed from 1998 to 2008 according to patient demographics, symptomatology, parameters of inflammation (peak WBC, peak CRP), position of the tip of the intussuscepted bowel and an intussusception bowel ratio (IBR).

Results

Of the 266 cases, 250 (94%) were successful (group A) and 16 (6%) failed (group B). Average age was significantly higher in group A than in group B (14.9 ± 12.4 vs. 8.33 ± 3.93 months) (P < 0.01). Duration of symptoms was significantly shorter in group A than in group B (15.0 ± 12.5 vs. 25.0 ± 9.7 h) (P < 0.05). The position of the tip was ascending colon (Ac): A = 34 (14%), B = 1 (6%); right transverse colon (RTc): A = 112 (45%), B = 1 (6%); left transverse colon (LTc): A = 84 (34%), B = 12 (75%); descending colon (Dc): A = 15 (6%), B = 0 (%); and sigmoid colon (Sc): A = 5 (2%), B = 2 (13%). The tip was located in LTc, Dc and Sc significantly more often in group B (14/16, 88%) than group A (104/250, 42%) (P < 0.01). IBR for group B (1.68 ± 0.47) was significantly larger than group A (1.13 ± 0.28) (P < 0.01). Differences in parameters of inflammation were not significant.

Conclusions

We found that the position of the tip and IBR are predictive of success of HRI. Having a dedicated team perform HRI using a standardized protocol with consideration of IBR and the position of the tip eliminates bias, fosters reliability and ensures reproducibility, while at the same time it allows patients with inappropriate data to be spared potentially dangerous attempted HRI.

Keywords

Intussusception Hydrostatic reduction Pediatric surgeon Radiographic findings Prediction 

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Toshiaki Takahashi
    • 1
  • Tadaharu Okazaki
    • 1
  • Hiroko Watayo
    • 1
  • Yuki Ogasawara
    • 1
  • Nana Nakazawa
    • 1
  • Yoshifumi Kato
    • 1
  • Geoffrey J. Lane
    • 1
  • Atsuyuki Yamataka
    • 1
  1. 1.Department of Pediatric General and Urogenital SurgeryJuntendo University School of MedicineTokyoJapan

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