scholarly journals Outcome of ultrasound guided reduction of intussusception in children by saline enema

2021 ◽  
Vol 8 (11) ◽  
pp. 3348
Author(s):  
Ansari Mohammed Abdul Muqtadir ◽  
Shweta Brajesh Gupta ◽  
Sarojini Pramod Jadhav
Keyword(s):  
Normal Saline ◽  
Operative Procedure ◽  
Ultrasound Guided ◽  
First Line ◽  
Duration Of Symptoms ◽  
Hydrostatic Reduction ◽  
Haemodynamic Stability ◽  
Select Group ◽  
Male Preponderance ◽  
The Mean

Background: Intussuception is a common cause of acute intestinal obstruction in children and contributor of morbidity and mortality in children. The purpose of this study was to evaluate efficacy of hydrostatic reduction of intussusception over operative reduction using normal saline enema in children and to identify procedure related complications.Methods: All patients presenting to us with features of intussusception clinically and confirmed by ultrasonography between June 2015 to November 2017 were included in study. Depending on haemodynamic stability of patient and surgeon’s preference, patients were subjected to trial of hydrostatic reduction by normal saline enema or operative procedure. Patients with failure or partial reduction were taken for surgery.Results: The mean age was 21.07 months with a male preponderance. Of 53 patients attending the institute, 32 were given a trial of hydrostatic reduction which was successful in 28. Thus success rate was 87.5%. 1 patient succumbed resulting in 1.4% mortality rate after the procedure. It was observed that longer duration of symptoms reduced chances of reduction. 88%patients with successful hydrostatic reduction were discharged within 4 days of admission.Conclusions: We conclude that ultrasound guided saline enema is simple ,safe and effective method of treating intussusception in children with low rate of complications and can be strongly recommended as first line of treatment of intussusception in select group of paediatric patient, especially those reporting early to the hospital.

scholarly journals Role of Ultrasound-Guided Hydrostatic Reduction of Intussusception in Children with Early Presentation

2015 ◽  
Vol 3 (2) ◽  
pp. 61-64
Author(s):  
Md Shakhawat Hossain ◽  
Md Ashraf Ul Huq ◽  
Jafrul Hannan ◽  
Kaniz Hasina ◽  
RN Sarker
Keyword(s):  
Small Intestine ◽  
Normal Saline ◽  
Study Group ◽  
Ultrasound Guided ◽  
First Line ◽  
Early Presentation ◽  
Hydrostatic Reduction ◽  
Initial Reduction ◽  
Early Case

General objective: To study the efficacy of Ultrasoundguided hydrostatic reduction of intussusception in children with early presentation.Methods: The study group included children aged 03 months to 02 years with early case of intussusception confirmed on ultrasonography. One litre of normal saline bag was suspended at 100 cm height from the patient’s level. After connecting the saline bag with Foley’s catheter introduced in the rectum, gradual distension of colon and retrograde movement of intussusceptum towards the caecum monitored by real time ultrasound.Successful reduction was assumed once mass was disappeared and passage of saline into the small intestine. If 1st attempt failed but there is some movement of the mass was present and child had no abdominal signs, 2nd and 3rd attempts were taken at least 30 min interval.Result: The overall success rate of US-guided hydrostatic reduction of intussusception in children with early presentation was about 90%, with no immediate recurrence and no perforation.Conclusion: Ultrasound guided hydrostatic reduction should be the first line of the treatment in patients with early presentation of intussusceptions aged between 3 months and 2 years old. In cases with failed initial reduction, a second or even third attempt may provide successful reduction.J. Paediatr. Surg. Bangladesh 3(2): 61-64, 2012 (July)

scholarly journals Clinical profile of parkinsonian disorders in the tropics: Experience at Kano, northwestern Nigeria

2012 ◽  
Vol 03 (03) ◽  
pp. 237-241 ◽  
Author(s):  
Owolabi Lukman Femi ◽  
A Ibrahim ◽  
S Aliyu
Keyword(s):  
Treatment Options ◽  
Age At Onset ◽  
Clinical Profile ◽  
Time Interval ◽  
Delayed Presentation ◽  
Drug Induced ◽  
Duration Of Symptoms ◽  
Male Preponderance ◽  
Idiopathic Parkinsonism ◽  
The Mean

ABSTRACT Background: No data exists on Parkinson’s disease (PD) and secondary Parkinsonism in Northwestern Nigeria. This study was designed to create a database, document the clinical profile of PD in Kano, northwestern Nigerian, and compare this to prior observations within and outside Nigeria. Materials and Methods: A database was documented on prospective patients presenting consecutively to the Neurology out-patients clinic of the two tertiary health facilities in Kano northwestern Nigeria over a period of 4 years. Demographic and clinical data at presentation were documented for all patients. Cases were classified as PD or secondary Parkinsonism. The severity at presentation and at last visit was classified using the H and Y scale. Results: Over a period of 4 years, out 1153 a total of 96 patients comprising 74 males and 22 females were enrolled. Eighty (83.3%) of them had clinically diagnosed PD while 16 (16.7%) had clinical features compatible with secondary Parkinsonism. The mean age at onset of symptoms in the PD patients (mean 58.2 ± 6.72 yrs ) was more than in secondary Parkinsonism (mean 51.4 ± 10.04 and P = 0.001). There was male preponderance in both idiopathic Parkinsonism (PD) (m:f = 3.2:1) and secondary Parkinsonism (m:f = 4.3:1). Out of the patients with secondary Parkinsonism, 10 (62.5%) and 5 (31.3%) had vascular Parkinsonism and drug-induced Parkinsonism, respectively. Duration of symptoms prior to presentation ranged between 3 months and 16 years. The mean (SD) time interval from the onset of motor symptoms to diagnosis of PD was 3.6 ± 3.4 yrs and time interval for men and women (male 3.8 ± 3.7; female 2.8 ± 2.1; P = 0.249). Conclusions: Clinical profile of patients with PD and secondary Parkinsonism in Kano is similar to that from other populations within Nigeria and other developing countries. However, delayed presentation, less frequent family history, lower frequency of Young-onset PD as well as treatment challenges occasioned by poverty, inadequacy of expert, and lack of newer drugs and treatment options contrasts the situation in western populations.

Ultrasound-guided hydrostatic reduction of ileo-colic intussusception in childhood: first-line management for both primary and recurrent cases

2021 ◽  
pp. 1-5
Author(s):  
Berat Dilek Demirel ◽  
Sertac Hancıoğlu ◽  
Basak Dağdemir ◽  
Meltem Ceyhan Bilgici ◽  
Beytullah Yagiz ◽  
...  
Keyword(s):  
Ultrasound Guided ◽  
First Line ◽  
Hydrostatic Reduction ◽  
Line Management

scholarly journals A Nine Case Series of Ultrasound-Guided Hydrostatic Reduction of Intussusception by Saline Enema

2013 ◽  
Vol 19 (1) ◽  
pp. 61-71
Author(s):  
Sornsupha Limchareon ◽  
Adisorn Boonyarit
Keyword(s):  
Case Series ◽  
Teaching Hospitals ◽  
Line Treatment ◽  
Ultrasound Guided ◽  
First Line ◽  
Hydrostatic Reduction ◽  
Pneumatic Reduction ◽  
Reduction Techniques ◽  
Enema Reduction ◽  
First Line Treatment

Non-surgical reduction of the intussusception is the first line treatment in children with intussusception. Among various radiological reduction techniques, barium enema reduction of the intussusception under fluoroscopy has been widely used in Thailand while pneumatic reduction under fluoroscopy has become popular in teaching hospitals. To our knowledge, ultrasound-guided hydrostatic reduction of the intussusception by saline enema (UGHSE) has never been used in Thailand. We reported 9 cases using UGHSE with 100% success rate without complication.

Early experience with ultrasound guided pneumatic reduction of intussusception using locally assembled equipment in Nepal

2019 ◽  
Vol 22 (2) ◽  
pp. 27-31
Author(s):  
Suman Bikram Adhikari
Keyword(s):  
Bowel Perforation ◽  
Pressure Gauge ◽  
Intraluminal Pressure ◽  
Invasive Technique ◽  
Duration Of Symptoms ◽  
Female Ratio ◽  
Hydrostatic Reduction ◽  
Pneumatic Reduction ◽  
Male Female Ratio ◽  
The Mean

Introduction: Intussusception is one of the commonest emergency conditions in children. Pneumatic reduction of intussusception, a minimally invasive technique, has a higher success rate and lower incidence of complications as compared to barium enema & hydrostatic reduction and also omits the need for unnecessary laparotomy. The aim of this study was to evaluate the results of the pneumatic reduction in our hospital as a treatment of idiopathic pediatric ileocolic intussusception and to identify the pretreatment factors associated with pneumatic reduction failure. Methods: This was a prospective analytical study. A total of 12 children were enrolled in the study between January to November 2018 at Nepal National Hospital, Kathmandu. Patients were given air enema under Ultrasound-guidance, using locally assembled equipment. All procedures were performed under intravenous anesthesia. The intraluminal pressure was monitored with a pressure gauge and was not permitted to go above 100 mmHg. A total of three attempts of 3 minutes each were allowed. Results: Average age of the patients was 2.7 years, with a male-female ratio of 3:1. Eleven (92%) of the cases were successfully reduced while 1 (8%) case failed to reduce. No bowel perforation occurred in this study. The mean duration of symptoms before presentation was 42 hours. The mean length of intussusceptum was 3.058 cm. the mean duration of pneumatic reduction was 1.97 minutes and total intervention time i.e. from induction of anesthesia to reversal from anesthesia was 18.55 minutes. Conclusion: The technique described is easy to assemble, safe and effective. I recommend it for regular use in pneumatic reduction of intussusception, especially in centers with limited resources.

Treatment Strategies for Recurrent Ileocolic Intussusceptions and a Novel Operative Procedure

2021 ◽  
Author(s):  
Mesut Demir ◽  
Melih Akın ◽  
Aydin Unal ◽  
Meltem Kalyoncu Kaba ◽  
Nihat Sever ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Group Treatment ◽  
Operative Technique ◽  
Operative Procedure ◽  
Treatment Strategies ◽  
Surgical Excision ◽  
Lead Point ◽  
Ultrasound Guided ◽  
Hydrostatic Reduction ◽  
Recurrent Intussusception

Abstract Background Intussusception is the most common cause of intestinal obstruction between 6 months and 36 months of age. There is no defined etiology in at least 75-90% of patients. Recurrent intussusception occurs in 5-16% of all intussusceptions and the treatment strategy is controversial in this patient group. Treatment of continued recurrent intussusception is a challenging problem when no lead point is revealed despite recurrence. We aimed to review our 10 years of experience in recurrent intussusception and describe a new operative technique for recurrent intussusception cases without any lead points. Results We retrospectively reviewed the data of patients with recurrent intussusception in our referral pediatric surgery clinic between 2007 and 2017. Ultrasound-guided hydrostatic reduction was performed on all patients. Surgery was performed on those patients who had findings of acute abdomen and complete intestinal obstruction or 2 failed attempts of UGHR for diagnostic purposes if a pathologic lead point was suspected based on patient findings and age. Laparoscopy or laparotomy was performed according to surgeon preference and experience. A total of 87 UGHRs were performed. Thirty-three patients were admitted to our clinic due to recurrent intussusception. The mean age was 12.75±14.14 (6 -84) months, and 19 were males and 14 were females. Abdominal pain, agitation and vomiting were common symptoms. UGHR was performed on all 33 patients on at least 2 different occasions. The time between the first and second UGHR treatments was 42.6 ± 186.19 (0-899) days. The success rate of the second UGHR was 27 out of 33 patients (81.8%). Surgery was performed on 6 patients. Manual reduction was performed on 5 patients and one was operated by the laparoscopic reduction of intussusception and Meckel’s diverticulum resection. Conclusions Surgeons should try to find permanent solutions for patients with multiple recurrent intussusceptions that are resistant to treatment. Surgical excision of the lead point will help prevent recurrent intussusception. Satisfactory results can also be obtained by ultrasound-guided hydrostatic reduction even in patients with recurrences. Laparoscopy is helpful in diagnosis, detection of lead points and treatment of irreducible intussusception. This new operative technique can be satisfactory for recurrent intussusceptions without any lead points.

SP3.2.6 Success of Ultrasound-Guided Reduction of Intussusception Using Normal/Saline And Factors Resulting In Failure of the Procedure

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Farooq Abdullah ◽  
Nadia Gulnaz
Keyword(s):  
Normal Saline ◽  
Ultrasound Guidance ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Ultrasound Guided ◽  
Hydrostatic Reduction ◽  
The Past ◽  
Clinical Signs And Symptoms ◽  
One Year ◽  
Surgery Department

Abstract Intussusception is one of the common pediatric surgical emergencies in age less than one year. The initial radiological study for detection of intussusception is ultrasound. Treatment of choice of intussusceptions has remained controversial and varies from center to center. Surgical exploration was the main treatment in the past and still practiced as first-line treatment in some centers. However, in the past few decades, there is a trend to reduce intussusception under radiological guidance. This study aims to determine the success rate of ultrasound-guided hydrostatic reduction of intussusception using normal saline and determination of possible factors that result in failure of the procedure. Methods This prospective study was conducted in the Pediatric Surgery department of Khyber Teaching Hospital, Peshawar from Jan 2018 to Sept 2018. All patients aged between 3 months to 24 months with clinical signs and symptoms and confirmatory sonographic evidence of intussusception were included in this study. The procedure was then carried out under ultrasound guidance using normal saline as a medium for reduction. Findings A total of 80 patients were included in this study. Successful reduction was achieved in 66 (82.5%) patients while in 14(17.5%) patients the procedure failed to reduce the intussusceptions. No mortality is reported in our study There were 6 recurrences 4 of which were managed by ultrasound guidance reduction while 2 underwent laparotomy. Conclusion Ultrasound-guided hydrostatic reduction of intussusception is an effective way to reduce the intussusception. It must be adopted as the primary procedure for the reduction of intussusception.

scholarly journals Incomplete Kawasaki disease - a diagnostic and therapeutic challenge

2014 ◽  
Vol 9 (4) ◽  
pp. 30-35
Author(s):  
S Datta ◽  
S Maiti ◽  
G Das ◽  
A Chatterjee ◽  
P Ghosh
Keyword(s):  
Kawasaki Disease ◽  
Intravenous Immunoglobulin ◽  
Incomplete Kawasaki Disease ◽  
Duration Of Symptoms ◽  
Clinical Criteria ◽  
Echocardiographic Finding ◽  
2D Echocardiography ◽  
Acquired Heart Disease ◽  
The Mean ◽  
One Year

Background The diagnosis of classical Kawasaki Disease was based on clinical criteria. The conventional criteria is particularly useful in preventing over diagnosis, but at the same time it may result in failure to recognize the incomplete form of Kawasaki Disease. Objective To suspect incomplete Kawasaki Disease, because early diagnosis and proper treatment may reduce substantial risk of developing coronary artery abnormality which is one of the leading causes of acquired heart disease in children. Method Nine cases of incomplete Kawasaki Disease were diagnosed over a period of one year. The diagnosis of incomplete Kawasaki Disease was based on fever for five days with less than four classical clinical features and cardiac abnormality detected by 2D- echocardiography. A repeat echocardiography was done after 6 weeks of onset of illness. The patients were treated with Intravenous Immunoglobulin and/or aspirin. Result The mean age of the patients was 3.83 years and the mean duration of symptoms before diagnosis was 12.1 days. Apart from other criteria all of our patients had edema and extreme irritability. All the patients had abnormal echocardiographic finding. Five patients received only aspirin due to nonaffordability of Intravenous Immunoglobulin and four patients received both aspirin and Intravenous Immunoglobulin, but the outcome was excellent in all the cases. Conclusion Incomplete Kawasaki Disease can be diagnosed with more awareness and aspirin alone may be used as a second line therapy in case of non affordability of Intravenous Immunoglobulin. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-4, 30-35 DOI: http://dx.doi.org/10.3126/jcmsn.v9i4.10234

scholarly journals POS1281 HOW DOES OBESITY INFLUENCE THE FEATURES OF KNEE OSTEOARTHRITIS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 923.4-924
Author(s):  
H. Hachfi ◽  
D. Khalifa ◽  
M. Brahem ◽  
N. Ben Chekaya ◽  
M. Younes
Keyword(s):  
Knee Osteoarthritis ◽  
Functional Impairment ◽  
Statistical Significance ◽  
Obese Group ◽  
University Hospital ◽  
Obese Patients ◽  
Cross Sectional ◽  
Duration Of Symptoms ◽  
Lequesne Index ◽  
The Mean

Background:Knee osteoarthritis and obesity are both major health problems. It is now admitted that the prevalence of knee osteoarthritis gets higher with obesity and that weight loss helps knee function and allows patients to avoid surgery.Objectives:The aim of this study was to study the influence of obesity on knee osteoarthritis features.Methods:A cross-sectional study was conducted in the university hospital Taher Sfar of Tunisia over a period of 6 months. Patients who had knee osteoarthritis confirmed by radiographs were included. Sociodemographic, clinical, radiological and therapeutic data were collected from medical records and visits. Obesity was defined by a body mass index (BMI) ≥30. Functional impairment was assessed by the Womac index and Lequesne index.Results:The study included 186 patients. There were 31 males and 155 femmes. The mean age was 60±10 years. The percentage of obese patients was 53,8%. The mean age was similar in both groups obese and non obese. There were more women in the obese group compared to the non obese group (p=0.0001), more patients who had diabetes mellitus and dyslipidemia (p=0.002). Non-obese patients had a shorter duration of symptoms with no statistical significance (p=0.151). Obese patients had more involvement of both knees (p<0.0001). Obesity did not have an impact on pain severity. Severity of radiological images (p=0,0001) were more frequent in obese patients. Functional impairment was similar in both groups. However, the percentage of patients having a very important functional impairment with Lequesne index was higher in obese patients (p<0.029). Obese patients also needed more physical therapy sessions (p=0.035).Conclusion:Knee osteoarthritis in obese patients is characterized with the femlae gender predominance, bilateral knee involvement, and a more severe images on radiographs. Thus the need for better control of weight and the importance of physical activity.References:[1]Coggon D, Reading I, Croft P, et al. Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord J Int Assoc Study Obes 2001; 25: 622–627.Disclosure of Interests:None declared

Modified endoscopic ultrasound-guided double-balloon-occluded gastroenterostomy bypass (M-EPASS): a pilot study

Endoscopy ◽  
2021 ◽  
Author(s):  
Amanda Marino ◽  
Ali Bessissow ◽  
Corey Miller ◽  
David Valenti ◽  
Louis Boucher ◽  
...  
Keyword(s):  
Gastric Outlet Obstruction ◽  
Endoscopic Ultrasound ◽  
Clinical Success ◽  
Outlet Obstruction ◽  
Stent Migration ◽  
Stent Insertion ◽  
Ultrasound Guided ◽  
Double Balloon ◽  
Low Residue Diet ◽  
The Mean

Abstract Introduction We recently developed a double-balloon device, using widely available existing technology, to facilitate endoscopic ultrasound-guided gastroenterostomy (EUS-GE). Our aim is to assess the feasibility of this modified approach to EUS-guided double-balloon-occluded gastroenterostomy bypass (M-EPASS). Methods This was a single-center retrospective study of consecutive patients undergoing M-EPASS from January 2019 to August 2020. The double-balloon device consists of two vascular balloons that optimize the distension of a targeted small-bowel segment for EUS-guided stent insertion. The primary end point was the rate of technical success. Results 11 patients (45 % women; mean [standard deviation (SD)] age 64.9 [8.6]) with malignant gastric outlet obstruction were included. Technical and clinical success (ability to tolerate an oral diet) were achieved in 91 % (10/11) and 80 % (8/10) of patients, respectively. There was one adverse event (9 %) due to stent migration. Two patients (18 %) required re-intervention for stent obstruction secondary to food impaction. The mean (SD) time to a low residue diet was 3.5 (2.4) days. Conclusion M-EPASS appears to facilitate the technique of EUS-GE, potentially enhancing its safety and clinical adoption. Larger studies are needed to validate this innovative approach to gastric outlet obstruction.

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