Ultrasound Guided Hydrostatic Versus Open Reduction in Intussusception
Ultrasound Guided Hydrostatic Reduction
Keywords:Ultrasound-guided Hydrostatic Reduction, Open Reduction, Intussusceptions, Successful Reduction, Recurrence, Hospital Stay
The surgical and nonsurgical technique has been utilized to manage intussusception. Surgical management of intussusceptions involves open laparotomy along with manual reduction. The non-surgical technique, Ultrasound-guided hydrostatic reduction (USGHR) is a renowned alternative technique for intussusception reduction. Objective: To compare the ultrasound-guided hydrostatic reduction versus open reduction for the management of intussusception in terms of successful reduction, recurrence, and hospital stay. Methods: It was a randomized controlled trial in which 158 cases were admitted through the Emergency Department of Pediatric Surgery of The Children’s Hospital Lahore, from August 2018 to August 2019. These patients were divided into 2 groups (79 in each group), Group A (ultrasound-guided hydrostatic reduction) and group B (open reduction). Data were collected through a questionnaire, which was entered into the computer using SPSS version 24.0. Results: Among 79 patients treated in-group A, 54.4% were up to 12 months old, and 67.1% males, in this group the hospital stay for 74.7% was 1-2 days and 74.7% had a successful reduction. In group B; patients treated in group B, 77.2% were up to 12 months old, and 72.2% were males. The hospital stay for 59.5% of patients was 5-7 days, and 83.5% had a successful reduction of intussusceptions. The recurrence was only in group B (3.8%) after the reduction of intussusceptions. Conclusion: The study concluded that ultrasound-guided hydrostatic is effective in terms of successful reduction, recurrence and hospital stay and should be preferred among children due to its safety and effectiveness.
Abantanga FA, Amoah M, Adeyinka AO, Nimako B, Yankey KP. Pneumatic reduction of intussusception in children at the Komfo Anokye Hospital, Kumasi, Ghana. East African Medical Journal. 2008 Feb; 85(11): 550-5. doi: 10.4314/eamj.v85i11.9672
Ellis H. The first successful elective laparotomy. Journal of perioperative practice. 2008 May; 18(5): 211-2. doi: 10.1177/175045890801800505
Riera A, Hsiao AL, Langhan ML, Goodman TR, Chen L. Diagnosis of intussusception by physician novice sonographers in the emergency department. Annals of emergency medicine. 2012 Sep; 60(3): 264-8.doi: 10.1016/j.annemergmed.2012.02.007
Ahmad MM, Wani MD, Dar HM, Mir IN, Wani HA, Raja AN. An experience of ultrasound-guided hydrostatic reduction of intussusception at a tertiary care centre. South African Journal of Surgery. 2016 May; 54(1): 10-3.
Talabi AO, Famurewa OC, Bamigbola KT, Sowande OA, Afolabi BI, Adejuyigbe O. Sonographic guided hydrostatic saline enema reduction of childhood intussusception: a prospective study. BMC emergency medicine. 2018 Dec; 18(1): 1-7. doi: 10.1186/s12873-018-0196-z
Huai Y, Yin Z, Zhou K. The comparison of pneumatic and hydrostatic reposition with surveillance of ultrasound in the treatment of intussusception. Biomedical Research. 2017 Jan ; 28(15): 6887-92.
Delhi N. Non-Operative Management of Intussusception in Children: A Single Surgeon's Experience. Chettinad Health City Medical Journal. 2016; 5(2): 60-3.
Mensah YB, Glover-Addy H, Etwire V, Twum MB, Asiamah S, Appeadu-Mensah W, et al. Pneumatic reduction of intussusception in children at Korle Bu Teaching Hospital: an initial experience. African Journal of Paediatric Surgery. 2011 May; 8(2): 176. doi: 10.4103/0189-6725.86057
Eraki ME. A comparison of hydrostatic reduction in children with intussusception versus surgery: Single-centre experience. African Journal of Paediatric Surgery: AJPS. 2017 Oct; 14(4): 61-4. doi: 10.4103/ajps.AJPS_102_16
Ogundoyin OO, Olulana DI, Lawal TA. Childhood intussusception: A prospective study of management trend in a developing country. African Journal of Paediatric Surgery: AJPS. 2015 Oct; 12(4): 217. doi: 10.4103/0189-6725.172541
Courtney SP, Ibrahim N, Longstaff AJ, Davidson CM. Intussusception in the adult: clinical, radiological and histological features. Postgraduate medical journal. 1992 Jun; 68(800): 449-52. doi: 10.1136/pgmj.68.800.449
Wood SK, Kim JS, Suh SJ, Paik TW, Choi SO. Childhood intussusception: US-guided hydrostatic reduction. Radiology. 1992 Jan; 182(1): 77-80. doi: 10.1148/radiology.182.1.1727313
Liu SJ. Enema reduction of intussusception by hydrostatic pressure under ultrasound guidance: a report of 377 cases. Journal of pediatric surgery. 1988 Sep 1; 23(9): 814-8. doi: 10.1016/S0022-3468(88)80229-X
Katz ME and Kolm P. Intussusception reduction 1991: an international survey of pediatric radiologists. Pediatric radiology. 1992 Sep; 22(5): 318-22. doi: 10.1007/BF02016243
Meyer JS. The current radiologic management of intussusception: a survey and review. Pediatric radiology. 1992 Sep; 22(5): 323-5. doi: 10.1007/BF02016244
Daneman A and Navarro O. Intussusception. Pediatric radiology.2004; 34: 97-108. doi: 10.1007/s00247-003-1082-7
Ugwu BT, Legbo JN, Dakum NK, Yiltok SJ, Mbah N, Uba FA. Childhood intussusception: a 9-year review. Annals of tropical paediatrics. 2000 Jun; 20(2): 131-5.
Bratton SL, Haberkern CM, Waldhausen JH, Sawin RS, Allison JW. Intussusception: hospital size and risk of surgery. Pediatrics. 2001 Feb; 107(2): 299-303. doi: 10.1542/peds.107.2.299
Ende ED, Allema JH, Hazebroek FW, Breslau PJ. Success with hydrostatic reduction of intussusception in relation to duration of symptoms. Archives of disease in childhood. 2005 Oct ; 90(10): 1071-2. doi: 10.1136/adc.2004.066332
Calder FR, Tan S, Kitteringham L, Dykes EH. Patterns of management of intussusception outside tertiary centres. Journal of pediatric surgery. 2001 Feb; 36(2): 312-5. doi: 10.1053/jpsu.2001.20704
Nayak D and Jagdish S. Ultrasound guided hydrostatic reduction of intussusception in children by saline enema: our experience. Indian Journal of Surgery. 2008 Feb; 70(1): 8-13.
How to Cite
Copyright (c) 2022 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments