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Childhood Intussusception: Role Of Ultrasound Guided Hydrostatic Reduction As A Primary Therapeutic Modality – Our Experience - Abstract

Prashant Sadashiv Patil, Gupta Abhaya, Kothari Paras L., Kekre Geeta, Deshmukh Shahaji, Apoorva Kulkarni, Vishesh Dikshit

 

Abstract

Background: To study the feasibility and efficacy of ultrasound guided saline enema hydroreduction as a primary therapeutic modality in cases of childhood intussusceptions in a tertiary care center.

Material and Methods: A retrospective review of cases of intussusceptions over a period of sixty months in a tertiary care center. Out of total fifty six patients with intussusception, seven were excluded from the study in view of poor selection criteria. Ultrasonography was the sole criteria for diagnosis and therapeutic purpose. Rest of the patients were subjected to saline enema hydroreduction. Successful reduction was considered achieved when saline refluxed to the distal ileum visualized by sonography.

Results: Forty nine patients were subjected to saline enema hydroreduction. Twenty two (44.89%) of them had presented within twenty four hours and got completely reduced by hydro-reduction whereas out of rest twenty seven (55.10 %) late presenters only thirteen were successfully reduced and rest of the patients had to be subjected to surgery.

Conclusion: Diagnosing intussusception in the first 24 hours will increase the rate of successful hydrostatic reduction and thus decrease the need for surgical intervention and prolonged hospitalization. Hence, we recommend saline enema reduction to be tried as the first choice in all cases of intus- susception unless contraindicated.

Keywords: childhood intussusception, hydrostatic saline enema reduction, exploratory laparotomy, resection and anastomosis.

 

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