Clinical Features and Outcome of Saline Hydrostatic Reduction in Patients with Intussusception in a Tertiary Care Centre

Abstract

Background: Intussusception is one of the most frequent causes of acute bowel obstruction in infants and toddlers. Abdominal sonogram is highly specific, accurate and is the first line diagnostic modality. The primary treatment options are non-operative hydrostatic or pneumatic reduction. In our institution, we use normal saline for reduction of intussusception under ultrasound guidance (USGR). The aim of the study is to analyse the clinical pattern and treatment outcome of intussusception. Methodology: Retrospective analysis of all cases admitted with intussusception in our department during 2014-2018 was done. Results: 785 cases (527 males: 258 females) with a mean age of 25 months and median of 16 months had abdominal pain (92.5%), vomiting (59%) and blood in stools (32%) as the predominant symptoms. 710/785 cases (90.4%) underwent successful USGR and 75/785 of the failed cases underwent surgery. Age group < 12 months, presence of blood in stools irrespective of its duration and prolonged vomiting >48 hours were found to be significant factors for failed USGR. Vomiting and blood in stools were found to be significantly higher in children <12 months of age (p<0.005), whereas pathological lead points were more frequent in children >3 years of age. Conclusion: With a high success rate and no significant complication rate, USGR is an effective non-operative treatment modality for intussusception. Age group <12 months, prolonged vomiting and presence of blood in stool were found to affect the success rate of hydrostatic reduction. Keywords: Intussusception, saline, ultrasound, hydrostatic reduction.