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Hydrostatic reduction of intussusception
in children: a single centre experience
Ramya Singrodia, Lalit Bharadia, Atul Gupta
Neoclinic Children Hospital, Nirman Nagar, Jaipur, Rajasthan
Introduction Algorithm of management
• Intussusception is a common surgical emergency in children especially in infants.
• Treatment of intussusception could be non-
operative or operative. Non-operative treatment (hydrostatic reduction) of intussusception is increasingly being practiced in developing countries.
• We present our experience with hydrostatic
saline reduction of intussusception in children at a paediatric hospital in Rajasthan.
Methods and Materials
• This retrospective study reviewed the hospital records of patients admitted with Intussusception over a one-year duration from April 2023 till March 2024.
• The data obtained included age, sex, clinical
presentation, symptom duration, diagnostic Discussion investigations, mode of treatment, length of According to a study done in Riyadh, Saudi Arabia, The diagnosis hospital stay and outcomes. was done by an ultrasound preceded by pneumatic enema reduction that was successful in 33 (80%) children. In our study though diagnosis was through USG but saline enema reduction • Ultrasound guided saline hydrostatic reduction was done which was successful in 20 (83%) children. was attempted as a first-line treatment for TABLE: Comparison between a previous study and our study intussusception in infants and children after outcomes appropriate stabilization. Surgery was resorted in those who had complications at presentation or in case of failure of hydrostatic reduction
Results • A total of 26 children (22 males, 4 females) were admitted with intussuception during the study period. The mean age was 18.7 months (range 4-48 months). • The majority presented with abdominal pain or Another study conducted at the Department of Surgery, Enugu State excessive cry (80.7%), vomiting (42.3%), and University rectal bleeding (15.4%). Fever at admission or in Teaching Hospital, Enugu, Nigeria , reported a male to female ratio of 4:1, with a mean the preceding week was present in 4 children age at presentation of 8 months. The majority of patients (45%) (15 %). presented after 48 • The mean duration of symptoms before hours of onset of their symptoms, eight patients (40%) between 24 to 48 hours while presentation was 2.64 days, and the mean three patients (15%) presented within 24 hours of onset of hospital stay was 2.69 days for all cases. symptoms • The diagnosis was done by an ultrasound. The mean age was 18.7 months (range 4-48 months) in our study. It deferred from this Ileocolic (92 %) was the most common study….the mean hospital stay across all cases was 2.69 days, and intussusception and remaining were colocolic. the average • Two (7.7%) children underwent surgery as initial number of hours of symptoms before presentation was 2.64days. management due to frank peritonitis at admission. Conclusions • Saline reduction was attempted in remaining 24 • Ileocolic was the most common site of patients and was successful in 20 (83%) children. Four children were resorted to surgery, intussusception. Abdominal pain was the laparotomy in four and laproscopy in two. most common manifestation followed by • Surgery included reduction in five and resection vomiting and rectal bleeding. and anastomosis in one child. For 5 out of 6, laparotomy reduction with appendectomy was • Hydrostatic saline reduction is a safe and done. Ileocolic intussusception (80.8%) was the effective non-surgical treatment option. most prevalent. No recurrence occurred in our cases. • Presence of rectal bleeding at admission and • Early detection and saline reduction may presentation after 24 hours of initial symptoms avert complication of rectal bleed and predicted need for surgery. need for surgery.
References 1. Reference: Alnamshan M, Almatroudi D, ALmutairi D, et al. (October 31, 2023) Idiopathic Intussusception in Infants and Children: Different Outcomes in Relation to Interventions. Cureus 15(10): e48026. DOI 10.7759/cureus.48026
2. Reference: Kevin Emeka Chukwubuike et al. Hydrostatic reduction of intussusception in children: a single centre experience. Pan African Medical Journal. 2020;36(263). 10.11604/pamj.2020.36.263.21380
