Efficacy of fluoroscopy-guided hydrostatic reduction of acute ileocolic intussusception in children-one center experience

Authors

  • Muhammad Afzal Sipra MCH, Dammam KSA.
  • Ammar Mustafa Ahmed Service resident Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam
  • Huda Hussain Abugrain Specialist Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam, Saudi Arabia
  • Ghulam Ali Ansari Specialist Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam
  • Mezzher Mohammad Alsaeed Service resident Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam
  • Aqeel Salman Alkhazal Service resident Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam
  • Layla Hussan Alnosair Service resident Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam

Keywords:

Children, Intussusception, Fluoroscopy, Hydrostatic reduction

Abstract

Abstract

Background: Intussusception is one of the common causes of acute abdomen in children with male preponderance. Most of the cases are idiopathic in origin. Abdominal ultrasound is the modality of choice to diagnose this condition. Reduction either by hydrostatic or pneumatic technique, is the first modality of the therapeutic approach, while failed cases necessitate surgical intervention.

Methods: In this retrospective study, 31 patients underwent fluoroscopy-guided hydrostatic reduction of ileocolic intussusception, between May 2017 to January 2023. The data of all patients, consisting of age, sex, and presenting complaint, were retrieved from the hospital's electronic database record. At presentation, all patients were adequately resuscitated, and all basic investigations were achieved.  The preliminary diagnosis of intussusception, based on history and examination, was confirmed by abdominal ultrasound, in all patients. The hydrostatic reduction was attempted in all cases lacking signs and symptoms of peritonitis and shock, irrespective of the duration of symptoms.  Patients with successful reduction were observed overnight and discharged the next day. Surgical intervention was performed in failed/incomplete reduction cases.

Results: Among 31 children (up to 5 years of age), 23 (74.20%) were male and 8 (25.80%) were female (male to female ratio: 2.8:1). In our study 58.06% cases presented within the first 24 hours of onset of symptoms, followed by 32.25% and 9.68% between 24-48 hours and 48-96 hours respectively. A high success rate (83.33%) was observed in patients who presented within 24 hours, followed by patients who presented between 24-48 hours (50%) and 48-96 hours (33.33%). Overall, hydrostatic reduction was successful in 67.74% of cases. Ten patients (32.26%) needed surgical intervention.

Conclusion: Fluoroscopy-guided hydrostatic reduction of intussusception is an effective therapeutic modality that avoids surgery and anesthesia-related risks. Early presenting patients showed a high success rate which signifies the importance of quick diagnosis. We suggest that if there is no contraindication, all cases, regardless of duration, should be attempted for hydrostatic reduction as late-presenting patients can also benefit from this modality

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Author Biographies

Muhammad Afzal Sipra, MCH, Dammam KSA.

Consultant Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam

Ammar Mustafa Ahmed, Service resident Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam

Service resident Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam

Huda Hussain Abugrain, Specialist Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam, Saudi Arabia

Specialist Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam, Saudi Arabia

Ghulam Ali Ansari, Specialist Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam

Specialist Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam

Mezzher Mohammad Alsaeed, Service resident Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam

Service resident Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam

Aqeel Salman Alkhazal, Service resident Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam

Service resident Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam

Layla Hussan Alnosair, Service resident Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam

Service resident Pediatric Surgery Department, Maternity and Children’s Hospital, Dammam

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Published

2024-01-15

How to Cite

1.
Sipra MA, Ammar Mustafa Ahmed, Huda Hussain Abugrain, Ghulam Ali Ansari, Mezzher Mohammad Alsaeed, Aqeel Salman Alkhazal, Layla Hussan Alnosair. Efficacy of fluoroscopy-guided hydrostatic reduction of acute ileocolic intussusception in children-one center experience. J Pediatr Adolesc Surg [Internet]. 2024Jan.15 [cited 2024Apr.17];2(2). Available from: http://jpedas.org/ojs/index.php/jpedas/article/view/172
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