Factors determining the need for operative reduction in children with intussusception: a population-based study

Sømme, Stig; To, Teresa; Langer, Jacob C.

doi:10.1016/j.jpedsurg.2005.12.047

Cited by 46 publications

(39 citation statements)

References 21 publications

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“…Radiologic reductions of intussusception had been shown to decrease length of hospitalization, shorten recovery, and reduce the risk of complications associated with major abdominal surgery [3]. The published success rate of radiologic reduction averages 80% but varies widely between 40% and 90% [4][5][6][7]. Previous studies have shown that children treated at a single children's hospital with more than 10,000 annual pediatric admissions had decreased operative utilization compared to other community hospitals with less pediatric admission volumes [5].…”

mentioning

confidence: 99%

The impact of hospital type and experience on the operative utilization in pediatric intussusception: a nationwide study

Jen

Shew

2009

Journal of Pediatric Surgery

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confidence: 99%

The impact of hospital type and experience on the operative utilization in pediatric intussusception: a nationwide study

Jen

Shew

2009

Journal of Pediatric Surgery

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“…Non-surgical reduction of intussusception is generally made under fluoroscopic guidance [27][28][29][30], even if USguided reduction may represent in the future a valid alternative to fluoroscopy as a less invasive guide in nonsurgical reduction of intussusception, avoiding exposition to ionizing radiations of little patients. The best studies about the use of US guide in intussusception reduction come from Asia, but nowadays also Europe is considering this technique.…”

Section: Discussionmentioning

confidence: 99%

Intussusception in childhood: role of sonography on diagnosis and treatment

Bartocci¹,

Fabrizi²,

Valente³

et al. 2014

J Ultrasound

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Objective The aim of this study was to determine the role of ultrasound in the diagnosis and treatment of pediatric patients with acute abdominal pain caused by intussusceptions. Materials and methods We performed a retrospective study of all pediatric patients with acute abdominal pain caused by intussusceptions and that underwent ultrasound examination at the emergency service of the Radiology Department between November 2007 and June 2013. The role of ultrasonography in the diagnosis of intussusceptions has been assessed by comparing the echographic presumptive diagnosis with the final diagnosis of discharge. Its importance in the treatment has been assessed by determining the value of ultrasound findings in the choice of the best treatment. Results The ultrasound examination was positive in 16/18 patients with a final diagnosis of intussusception. Some sonographic findings seemed to be able to predict the opportunity to resort to non-surgical therapeutic options like hydrostatic or pneumatic reduction of the intestinal segments invaginated. In our casuistry, five children presented characteristics typical of this subgroup and underwent barium enema which provided the reduction of the intestinal segments involved. The future challenge will be to perform non-surgical ultrasound-guided reductions to avoid the exposure of the infants to ionizing radiations. Conclusions Ultrasonography is essential not only in the diagnosis, but also it adds important elements in the therapeutic choice and could play in the future an important role in non-surgical reduction of intestinal intussusceptions in pediatric patients.Keywords Intussusception Á Childhood Á Sonography Riassunto Obiettivo Accertare il ruolo dell'ecografia nella diagnosi e trattamento dei pazienti pediatrici con dolore addominale acuto causato da invaginazione intestinale. Materiali e metodi Abbiamo eseguito uno studio retrospettivo su tutti i pazienti pediatrici con dolore addominale acuto causato da intussuscezione e sottoposti ad esame ecografico presso il servizio di emergenza del Dipartimento di Radiologia tra il Novembre 2007 ed il Giugno 2013. Il ruolo dell'ecografia nella diagnosi di intussuscezione è stato valutato comparando la diagnosi presuntiva ecografica con la diagnosi finale di dimissione; per ciò che concerne la sua importanza nel trattamento, ci si è basati sull'influenza dei reperti ecografici sul percorso terapeutico. Risultati Su 18 pazienti con diagnosi finale di intussuscezione l'esame ecografico è risultato positivo in 16 casi; inoltre è stato possibile osservare che alcuni reperti ecografici sembrano essere in grado di predire l'opportunità di ricorrere ad opzioni terapeutiche non chirurgiche, vale a dire riduzione idrostatica o pneumatica del segmento intestinale invaginato. Nella nostra casistica, 5 bambini hanno presentato caratteristiche tali da rientrare in questo sottogruppo, e pertanto sono stati sottoposti a clisma opaco, 123J Ultrasound (2015( ) 18:205-211 DOI 10.1007 tramite cui in 3 casi si è ottenuto lo svaginam...

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“…8 Enema reduction is successful 61%-90% of the time. [9][10][11][12][13][14][15] The success rate of the procedure is improved if a diagnosis of intussusception is prompt and enema is performed within 12 hours after the onset of symptoms. 13 If enema reduction measures are not successful, operative intervention is required.…”

Section: Introductionmentioning

confidence: 99%

“…13 If enema reduction measures are not successful, operative intervention is required. 6,15 Approximately 25% of patients with intussusception will ultimately require an operation, and of those, approximately 27% will require a bowel resection. 15 Recently, attempts at laparoscopic management have been determined to be safe and effective with an approximately 10%-30% conversion rate to an open procedure.…”

Section: Introductionmentioning

confidence: 99%

“…6,15 Approximately 25% of patients with intussusception will ultimately require an operation, and of those, approximately 27% will require a bowel resection. 15 Recently, attempts at laparoscopic management have been determined to be safe and effective with an approximately 10%-30% conversion rate to an open procedure. [16][17][18][19] Laparoscopic management reduces the length of hospital stay and hospital costs without a change in postoperative complications.…”

Section: Introductionmentioning

confidence: 99%

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