How is hydrostatic reduction for intussusception done?
Sonography has now been accepted as a method for guiding hydrostatic reduction of intussusception with tap water, normal saline or Ringer’s lactate solution. This method is currently being used at Korle Bu Teaching Hospital. It is a very simple, efficient, economical and quick method of managing intussusception.
How is an intussusception reduced?
Using either fluoroscopic or ultrasound guidance, reduction of intussusception can be performed with air (i.e. pneumatic) or contrast (i.e. hydrostatic) enemas. The only proven benefit of the ultrasound-guided technique is the decreased radiation exposure.
What is the nonsurgical treatment of choice for a child with intussusception?
Air enema is the treatment of choice in many institutions. The risk of major complications with this technique is small. Its success is decreased, as with other reducing agents, in patients with small bowel intussusceptions and in those with prolapsing intussusceptions.
What is a hydrostatic enema?
Purpose: Hydrostatic enema is the gold standard treatment for ileocolic intussusception in stable patients without radiologic complication. There is no consensus about the influence of long history of symptoms in the outcome of this treatment.
How is hydrostatic reduction performed?
The child is placed in the plastic enema ring, and an 18-F Foley catheter is inserted into the rectum. Figure 3. Continuous US guidance is provided during hydrostatic reduction. During the procedure, the child’s buttocks are held together to form a tight seal to reduce leakage of fluid.
How do you manually reduce intussusception?
After inspection for signs of perforation, the intussusception is identified and delivered into the wound. First, an attempt is made at manual reduction by retrograde milking of the intussusceptum. Although gentle pulling may aid in reduction, avoid vigorous pulling apart of the intussuscepted segment of bowel.
Can intussusception fix itself?
Sometimes intussusception will repair itself while a child has a barium enema. In many cases, the healthcare provider can correct the problem by giving an air enema or saline enema. This is done by placing a small tube in your child’s rectum.
Why do you treat intussusception with a barium enema?
Doctors use a therapeutic enema to help identify and diagnose intussusception. This is a serious disorder in which one part of the intestine slides into another in a telescoping manner and causes inflammation and possibly an intestinal obstruction.
What is pneumatic reduction?
It is the most common cause of bowel obstruction in the infant-toddler age group. Pneumatic reduction of intussusception has been practiced since 1950. It involved per rectal insufflations of air at a pressure of between 80 and 100 mmHg.
What is bowel interception?
Intussusception (in-tuh-suh-SEP-shun) is a serious condition in which part of the intestine slides into an adjacent part of the intestine. This telescoping action often blocks food or fluid from passing through.
When to use an enema for intussusception?
Purpose: Intussusception is a common surgical emergency in infants and children. The incidence of intussusception is from one to four per 2,000 infants and children. If there is no peritonitis, perforation sign on abdominal radiographic studies, and nonresponsive shock, nonoperative reduction by pneumatic or hydrostatic enema can be performed.
When to use pneumatic or hydrostatic enema?
If there is no peritonitis, perforation sign on abdominal radiographic studies, and nonresponsive shock, nonoperative reduction by pneumatic or hydrostatic enema can be performed. The purpose of this study was to compare the success rates of both the methods. Methods: Two institutional retrospective cohort studies were performed.
How does hydrostatic reduction of intussusception work?
Technique All children with suspected intussusception are assessed by the pediatric surgeon prior to arrival at the ultrasound suite. If the US scan is positive for intussusception, informed consent is obtained for hydrostatic reduction. An intravenous line is set up and blood samples are taken for electrolytes and cross-matching.
What’s the success rate of nonoperative reduction of intussusception?
The method of nonoperative reduction of intussusception was dependent on the experience of the radiologist or pediatric surgeon and the hospital setting. We found the success rate of pneumatic reduction was 1.48 times more than that of barium reduction in this study.