Factors associated with surgical treatment in pediatric intussusception

Peyvasteh, Mehran; Askarpour, Shahnam; Ghanavati, Mehdi; Javaherizadeh, Hazhir

doi:10.1007/s10354-022-00953-y

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…Several studies [1,8,17] have observed a decrease in the effectiveness of non-invasive procedures when the duration of symptoms exceeds 24 h. We did not obtain analogous results, as in our case results were statistically insignificant. This might indicate that children with prolonged symptoms should not be denied non-operative treatment solely based on this factor.…”

Section: Discussioncontrasting

confidence: 79%

“…Potential correlation between the need for surgical treatment and clinical manifestations has been previously studied. In the study published by Flaum et al [13], clinical symptoms were not associated with the reduction success; however, Fike et al [8] and Peyvasteh et al [17] recognized currant jelly stool and the presence of free peritoneal fluid as failure factors in the non-surgical treatment.…”

Section: Discussionmentioning

confidence: 95%

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Predictive factors for failure of nonsurgical management of intussusception and its in-hospital recurrence in pediatric patients: a large retrospective single-center study

Chrapusta,

Preinl,

Łubniewska

et al. 2024

Egypt Pediatric Association Gaz

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Background This study explores the effectiveness of ultrasonography (USG)-guided saline enema reduction for ileocecal intussusception. It investigates factors, ascertainable through physical examination, ultrasound, and medical history, that impact the success of the procedure and the likelihood of recurrence. Results Conducted at a tertiary referral center, the study included 323 pediatric cases diagnosed with intussusception between 2017 and 2023. Patient data, symptoms, signs, and outcomes were collected. Hydrostatic saline enema, performed under USG guidance, served as the primary non-operative treatment. Logistic regression models assessed the impact of clinical factors on success and recurrence rates. Out of 323 patients examined for eligibility, 184 met inclusion criteria and were analyzed. Successful reduction with saline enema was achieved in 86.7%. In-hospital recurrence occurred in 17.1%, notably higher for intussusceptions extending into the rectum (p < 0.03). Pathologic lead point was identified in 33.3% of operated cases. The study revealed a correlation between the increasing number of symptoms (p < 0.001) and reduced success rates in enema reduction, with vomiting (p < 0.02), diarrhea (p < 0.05), and peritoneal fluid (p < 0.008) negatively affecting outcomes. Symptom duration of 1–9 h (p < 0.001) and 10–24 (p < 0.01) correlated with higher success rates, but prolonged symptom duration of > 24 (p = 0.4) and 48–72 (p = 0.2) hours did not decrease chances for successful reduction. Conclusions Prolonged symptom duration of over 24 and 48–72 h should not be a definitive contraindication for non-operative treatment. Cumulation of symptoms typical for intussusception might reduce the chances of success. These findings contribute valuable insights into optimizing non-operative strategies for managing pediatric intussusception.

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Section: Discussioncontrasting

confidence: 79%