Ileocolic intussusception and hydrostatic reduction in a 2-year-old girl

Hydrostatic reduction of ileocolic intussusception by barium enema is uniformly regarded as optimal management, with surgical treatment reserved for occasions when this is not successful and for other selected circumstances.1 In an attempt to maximize the success rate of hydrostatic reduction, we examined the effect of analgesic premedication on both the outcome for the barium study and the operative findings. MATERIALS AND METHODS The case records and radiographs of 76 children with ileocolic intussusception treated at the Yale-New Haven Hospital between Jan 1, 1974, and Dec 31, 1984, were reviewed for patient age, sex, seasonal incidence, presenting signs and symptoms, and results of hydrostatic reduction, as well as surgical treatment with operative findings, morbidity, and mortality.

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Shear wave elastography evaluation in predicting the success of ultrasound-guided saline enema hydrostatic reduction technique in ileocolic intussusception

Acta Radiologica ◽

10.1177/02841851211018799 ◽

2021 ◽

pp. 028418512110187

Author(s):

İsmail Akdulum ◽

Enes Gürün ◽

Melih Akyüz ◽

Ramazan Tiken ◽

Hayrunnisa Oral ◽

...

Keyword(s):

Shear Wave ◽

Shear Wave Elastography ◽

Primary Treatment ◽

Distal Portion ◽

Intestinal Wall ◽

Ileocolic Intussusception ◽

Ultrasound Guided ◽

Hydrostatic Reduction ◽

Stiffness Measurement ◽

Ileocecal Intussusception

Background Intussusception is the invagination of the proximal intestinal segment into the distal portion. Reduction procedures with fluid or air have been used as the primary treatment of choice in clinically stable children. Purpose To evaluate the role of intestinal wall elasticity measurements by shear wave elastography (SWE) to predict the success of ultrasound-guided saline enema (USGSE) reduction. Methods USGSE was performed, if not contraindicated otherwise, after the diagnosis of ileocecal intussusception via the ultrasound (US). The length and diameter of the intussusception and the median stiffness of the intestine were measured before USGSE. Results Seventeen children were diagnosed with ileocolic intussusception via grayscale US assessment. Two children whose SWE images became artifacts due to inadaptability were excluded from the study. Thus, the study involved 15 patients (9 boys, 6 girls; age range = 11–48 months). There was no statistically significant association between age and median stiffness measurement in kilopascal (kPa). ( P > 0.05). A moderate positive correlation was observed between the median stiffness measurement (kPa) and the length of intussusception (r = 0.547; P = 0.035). There was no statistically significant relationship between median stiffness measurement (kPa) and short-axis diameter of intussusception ( P > 0.05). Conclusions Stiffness assessment of the intestinal wall in ileocolic intussusception during the US examination, which is the gold standard in the intussusception assessment, can be used as a new criterion for predicting the performance of the USGSE technique and might be useful in making decisions regarding the clinical management of ileocolic intussusception.

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The incidence of negative intraoperative findings after unsuccessful hydrostatic reduction of ileocolic intussusception in children: A retrospective analysis

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2018.05.006 ◽

2019 ◽

Vol 54 (3) ◽

pp. 500-506 ◽

Cited By ~ 3

Author(s):

Maadrika M.N.P. Kanglie ◽

Nanko de Graaf ◽

Femke Beije ◽

Elise M.J. Brouwers ◽

Sabine D.M. Theuns-Valks ◽

...

Keyword(s):

Retrospective Analysis ◽

Ileocolic Intussusception ◽

Hydrostatic Reduction

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Ileocolic intussusception: Hydrostatic reduction in the presence of the dissection sign

Pediatric Radiology ◽

10.1007/bf02387971 ◽

1986 ◽

Vol 16 (6) ◽

pp. 514-515 ◽

Cited By ~ 2

Author(s):

J. F. Johnson ◽

W. E. Shiels

Keyword(s):

Ileocolic Intussusception ◽

Hydrostatic Reduction

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THE REDUCTION OF INTUSSUSCEPTION BY HYDROSTATIC PRESSURE

PEDIATRICS ◽

10.1542/peds.25.4.561 ◽

1960 ◽

Vol 25 (4) ◽

pp. 561-562

Author(s):

THOMAS V. SANTULLI

Keyword(s):

Surgical Treatment ◽

Hydrostatic Pressure ◽

Barium Enema ◽

Surgical Procedure ◽

Primary Method ◽

Ileocolic Intussusception ◽

Hydrostatic Reduction ◽

Advantages And Disadvantages ◽

Proper Role

THE ARTICLE by Robins and Plenk which appears in this issue of Pediatrics is representative of the experience on the operative and non-operative forms of treatment of intussusception in childhood which is being reported by many others. Although the series is too small to draw any valid conclusions, the authors have attempted to show that reduction by barium enema will save about a half of these patients a surgical procedure, and they have called our attention to the advantages and disadvantages of hydrostatic reduction. The treatment is still controversial and there is uncertainty regarding the proper role, if any, of hydrostatic reduction of intussusception. Some of the proponents of the surgical treatment still maintain that operation is the only form of treatment for all cases of ileocolic intussusception, while other authors are equally adamant in the use of hydrostatic pressure as the primary method of reduction.

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