Pneumatic reduction of ileocolic intussusception in children

Miles, S G; Cumming, William A.; Williams, John A.

doi:10.1007/bf02395749

Cited by 17 publications

(4 citation statements)

References 2 publications

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“…Our pressure of 80mmHg is less than the 120 mm Hg recommended by Miles et al in their report of 4 patients [7] but is in keeping with the recommendation of large series [1][2][3][4]. It may be that as experience is gained, we will employ higher pressures, less stringent selection criteria and more prolonged reduction attempts, but during this introductory phase we prefer the conservative approach.…”

Section: Discussionsupporting

confidence: 67%

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Gas reduction of intussusception

Campo

Phelan

1989

Pediatr Radiol

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Efforts to improve the non-surgical management of childhood intussusception centre around (a) reassessment of selection criteria used to ensure as many children as possible have the advantage of hydrostatic reduction, and (b) improvements and modifications of enema technique to ensure successful and safe reductions without increased morbidity. Reports that pneumatic reduction was highly successful in treating childhood intussusception prompted the authors to evaluate this technique over an 18 month period using our previously reported technique of oxygen at 2 litres/minute and a pressure of 80 mm Hg. Pneumatic reduction was attempted in 114 of 129 consecutive cases of intussusception, and was successful in 85 (75%). Fifteen patients (8.6%) were considered unacceptable risks for gas reduction using our current selection criteria and had primary surgery. The overall success rate considering all cases of intussusception managed at our institution over this period was 66% (85/129). As with any form of hydrostatic reduction, pneumatic reduction of intussusception requires careful selection of patients, meticulous technique, and awareness of complications and their appropriate management. Because of its simplicity and improved success rate, pneumatic reduction has replaced traditional barium reduction at our institution. It may be that with further evaluation of selection criteria, higher pressures, and prolonged attempts that results will improve further.

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Section: Discussionsupporting

confidence: 67%

“…Although pneumatic reduction of intussusception has been extensively used in some countries [1][2][3][4] there are relatively few reports [5][6][7] of its use and effectiveness from institutions outside China.…”

mentioning

confidence: 99%

Gas reduction of intussusception

Campo

Phelan

1989

Pediatr Radiol

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“…Hydrostatic reduetion has been widely used for the diagnosis and treatment of uncomplicated intussusception (1,4,12,18). Pneumatic reduction using air or oxygen (17) un-der x-ray fluoroseopy, on the other hand, is not commonly used, in spite of favourable results having been aehieved (Table 2) (5,8,13,14,15,16), probablybecauseofpoorvisualization. However, this is clean, cheap and convenient, and does not entail the problems of water intoxication or barium peritonitis.…”

Section: Discussionmentioning

confidence: 99%

“…A short interval between onset and treatment apparently increases the rate of successful reduction (6,24), and early diagnosis is obviously necessary in non-operative reduction. Although bowel obstruetion might not be a eontraindication 10 attempt non-operative reduction (1,6,15), still it would be apremature concept (7).…”

Section: Discussionmentioning

confidence: 99%

Air Reduction for Intussusception in Infancy and Childhood:Ultrasonographic Diagnosis and Management Without X-Ray Exposure

et al. 1990

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For the treatment of uncomplicated intussusception in infants and children, we attempted air reduction without x-ray study to avoid the genetic and carcinogenic effects of radiation. Intussusception could generally be diagnosed by ultrasonography in addition to the history and typical clinical signs without using a barium enema. The success of reduction could also be safely evaluated from the disappearance of both the characteristic sonographic target sign and the abdominal palpable mass, and improvement in the general condition 2 or 3 hours after completing this procedure. This simple, cheap and clean reduction method was applied to 127 patients under strict indications and sedation with diazepam. The successful reduction rate was high (90.6%) and equal to that by hydrostatic reduction. Accordingly, this procedure appears to be safely applicable to the management of uncomplicated intussusception in infancy and childhood.

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Effectiveness of pneumatic reduction of ileocolic intussusception in children

Menor¹,

Cortina²,

Marco³

et al. 1992

Gastrointest Radiol

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A total of 158 consecutive therapeutic air enemas were performed upon 133 patients during a 2-year period. Perforation and/or an impairment of the general condition of the children were the only main contraindications for the reduction attempt (five patients). Successful reductions were achieved in 89% of cases with no complications. Operation was performed in all 17 cases of unsuccessful reduction: resection in four cases, easy manual reduction in nine, difficult manual reduction in two, and spontaneous reduction in two. There were 16 (12%) patients with one or more recurrent episodes. In 23 (16%) cases, following pneumatic reduction, a swollen ileocecal valve showing a multiple appearance was observed. This fact sometimes results in a differential diagnosis with incomplete reduction; in all these cases, small bowel aeration was always a sign of complete reduction. No significant difference was noted between a swollen ileocecal valve and patient age, duration of symptoms, presence of small bowel obstruction, and further recurrences. Air enema has improved our previous success obtained with hydrostatic reduction (79%), as well as being a simpler, cleaner, and faster technique for intussusception reduction in children.

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Pneumatic reduction of ileocolic intussusception in children

Cited by 17 publications

References 2 publications

Gas reduction of intussusception

Gas reduction of intussusception

Air Reduction for Intussusception in Infancy and Childhood:Ultrasonographic Diagnosis and Management Without X-Ray Exposure

Effectiveness of pneumatic reduction of ileocolic intussusception in children

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