Abstract
Purpose
Intussusception is the most common cause of acute abdomen in infants and preschool children. Nonoperative reduction using air enema is an established treatment in children with intussusception. The aim of this study was to determine whether length of the history influences the outcome of pneumatic reduction of intussusception in children?
Methods
The medical records of 256 consecutive children with intussusception between July 1998 and June 2010, who underwent air enema reduction regardless of the length of the history were reviewed. In all 256 patients, intussusception was confirmed by ultrasound before proceeding to air enema.
Results
The length of history ranged from 2 to 240 h with median time of 18.5 h. The median age in 256 patients was 7 months (range 1 day to 12 years). The presenting clinical features included irritability/abdominal pain (77%), vomiting (80%), bleeding per rectum (36%) and palpable abdominal mass (50%). Air enema reduction was successful in 234 (91.5%) of the 256 patients. In 22 (8.5%) patients, air enema failed to reduce the intussusception and 3 (1.1%) of these patients had colonic perforation during the procedure. All 22 patients required surgery. The duration of symptoms did not influence the outcome of pneumatic reduction. 37 (14%) patients developed recurrence after successful pneumatic reduction of intussusception, with 58% presenting within 48 h of the initial procedure.
Conclusion
Our data suggest that pneumatic reduction should be first-line treatment in all children with intussusception regardless of the length of the history.
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References
Justice FA, Auldist AW, Bines JE (2006) Intussusception: trends in clinical presentation and management. J Gastroenterol Hepatol 21(5):842–846
Grosfeld JL (2005) Intussusception then and now: a historical vignette. J Am Coll Surg 201(6)
Davis CF, McCabe AJ, Raine PAM (2003) The ins and outs of intussusception: history and management over the past fifty years. J Pediatr Surg 38(Suppl 7):60–64
Macdonald I, Beattie T (1995) Intussusception presenting to a paediatric accident and emergency department. J Accid Emerg Med 12:182–186
Harrington L, Connolly B, Hu X, Wesson DE, Babyn P, Schuh S (1998) Ultrasonographic and clinical predictors of intussusception. J Pediatr 132:836–839
Lehnert T, Sorge I, Till H, Rolle U (2009) Intussusception in children—clinical presentation, diagnosis and management. Int J Colorectal Dis 24:1187–1192
Justice F, Auldist A, Bines J (2006) Intussusception: trends in clinical presentation and management. J Gastroenterol Hepatol 21:842–846
McDermott VG, Taylor T, Mackenzie S, Hendry GMA (2009) Pneumatic reduction of intussusception: clinical experience and factors affecting outcome. Clin Radiol 64(7):655–663
Saxena AK, Höllwarth ME (2007) Factors influencing management and comparison of outcomes in paediatric intussusceptions. Acta Paediatr 96(8):1199–1202
Ramachandran P, Gupta A, Vincent P, Sridharan S (2008) Air enema for intussusception: is predicting the outcome important? Pediatr Surg Int 24(3):311–313
Gorenstein A, Raucher A, Serour F, Witzling M, Katz R (1998) Intussusception in children: reduction with repeated, delayed air enema. Radiology 206:721–724
Rubi I, Vera R, Rubi SC, Torres EE et al (2002) Air reduction of intussusception. Eur J Pediatr Surg 12(6):387–390
Shapkina AN, Shapkin VV, Nelubov IV, Pryanishena LT (2006) Intussusception in children: 11-year experience in Vladivostok. Pediatr Surg Int 22(11):901–904
Guo JZ, Ma XY, Zhou QH (1986) Results of air pressure enema reduction of intussusception: 6,396 cases in 13 years. J Pediatr Surg 21:1201–1203
Stein M, Alton DJ, Daneman A (1992) Pneumatic reduction of intussusception: 5-year experience. Radiology 183:681–684
Blanch A, Perel S, Acworth P (2007) Paediatric intussusception: epidemiology and outcome emergency medicine Australasia 19:45–50
Champoux AN, Del Beccaro MA, Nazar-Stewart V (1994) Recurrent intussusceptions: risks and features. Arch Pediatr Adolesc Med 148:474–478
Fecteau A, Flageole H, Nguyen LT, Laberge J-M, Shaw KS, Guttman FM (1996) Recurrent intussusception: Safe use of hydrostatic enema. J Pediatr Surg 31(6):859–861
Daneman A, Navarro O (2004) Intussusception. Part 2: an update on the evolution of management. Pediatr Radiol 34:97–108
Ko HS, Schenk JP, Tröger J, Rohrschneider WK (2007) Current radiological management of intussusception in children. Eur Radiol 17(9):2411–2421
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Tareen, F., Ryan, S., Avanzini, S. et al. Does the length of the history influence the outcome of pneumatic reduction of intussusception in children?. Pediatr Surg Int 27, 587–589 (2011). https://doi.org/10.1007/s00383-010-2836-6
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DOI: https://doi.org/10.1007/s00383-010-2836-6