Twenty years' experience for reduction of ileocolic intussusceptions by saline enema under sonography control.

Détails

ID Serval
serval:BIB_BE40C044A65F
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Twenty years' experience for reduction of ileocolic intussusceptions by saline enema under sonography control.
Périodique
Journal of pediatric surgery
Auteur(s)
Flaum V., Schneider A., Gomes Ferreira C., Philippe P., Sebastia Sancho C., Lacreuse I., Moog R., Kauffmann I., Koob M., Christmann D., Douzal V., Lefebvre F., Becmeur F.
ISSN
1531-5037 (Electronic)
ISSN-L
0022-3468
Statut éditorial
Publié
Date de publication
01/2016
Peer-reviewed
Oui
Volume
51
Numéro
1
Pages
179-182
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Résumé
Ultrasonography is a well-established efficient diagnostic tool for ileocolic intussusceptions in children. It can also be used to control hydrostatic reduction by saline enemas. This reduction method presents the advantage of avoiding radiations. Parents can even stay with their children during the procedure, which is comforting for both. The purpose of this study was to present our 20 years' experience in intussusception reductions using saline enema under ultrasound control and to assess its efficiency and safety.
This retrospective single center study included patients with ileocolic intussusceptions diagnosed by ultrasound between June 1993 and July 2013. We excluded the data of patients with spontaneous reduction or who underwent primary surgery because of contraindications to hydrostatic reduction (peritonitis, medium or huge abdominal effusion, ischemia on Doppler, bowel perforation). A saline enema was infused into the colon until the reduction was sonographically confirmed. The procedure was repeated if not efficient. Light sedation was practiced in some children.
Eighty-tree percent of the reductions were successful with a median of 1 attempt. Reduction success decreased with the number of attempts but was still by 16% after 4 attempts. The early recurrence rates were 14.5%, and 61.2% of those had a successful second complete reduction. Forty-six patients needed surgery (11 of them had a secondary intussusception). Sedation multiplies success by 10. In this period, only one complication is described.
Ultrasound guided intussusception reduction by saline enema is an efficient and safe procedure. It prevents exposure of a young child to a significant amount of radiation, with similar success rate. We had very low complication rate (1/270 cases or 3‰). The success rate could be increased by standardized procedures including: systematic sedation, trained radiologists, accurate pressure measurement, and number and duration of attempts.

Mots-clé
Enema/adverse effects, Enema/methods, Female, Humans, Ileal Diseases/diagnostic imaging, Ileal Diseases/therapy, Infant, Intussusception/diagnostic imaging, Intussusception/therapy, Male, Recurrence, Retrospective Studies, Sodium Chloride/administration & dosage, Treatment Outcome, Ultrasonography, Children, Intussusception, Radiation, Reduction, Saline enema, Sonography, Ultrasound
Pubmed
Web of science
Création de la notice
28/08/2017 14:48
Dernière modification de la notice
20/08/2019 16:32
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