Pneumatic reduction of intussusception in children at Korle Bu Teaching Hospital: An initial experience

Abstract

Pneumatic reduction of intussusception is a cost-effective and rapid method of management of intussusception. It however has limitations like high reported rate of bowel perforation and limited ability to identify lead points. The benefits however seem to outweigh these challenges, such as fluoroscopic-guided pneumatic reduction has a very high success rate. Fluoroscopic guided pneumatic reduction should be considered as one of the primary modes of reduction in Ghana and other neighbouring countries that are yet to practice it.

A review of intussusception cases involving failed pneumatic reduction and re-intussusception

“…[5] In the present series, a total of 25 laparotomies were performed, and pathological lead points were identified in 6 of these patients (Meckel's diverticulum in 5 cases, juvenile polyp in 1 case). Perforation was observed during the PR procedure in 3 of the 5 patients with Meckel's diverticulum.…”

“…[3] As experience with PR increases, the rate of complications decreases, procedure time is shortened, and consequently, the exposure to radiation decreases. [5,13] PR performed by inexperienced teams is reported to have lower success rates and higher rates of complication. [5] PR procedures at the present clinic are performed under standard operating conditions with fluoroscopic guidance.…”

“…[1][2][3][4] The success rate of PR was found to be 88-95%. [3,5] The pneumatic method has other advantages, as well. It may be used in the diagnosis and treatment of intussusception, and it carries a lower radiation risk, compared to hydrostatic reduction.…”

“…Moreover, in the event of perforation, there will be less peritoneal spread, corresponding to a lower rate of morbidity and mortality. [5] For these reasons, many publications recommend PR as a firstline treatment. [3] The open surgery method was the former first-line treatment at the present institution, but PR has increasingly taken its place, particularly over the past decade, [6] and the PR success rate is 95%.…”

“…In the present study, it was particularly noteworthy that free intraabdominal fluid was found on USG in 80% of cases that included perforation. [1,5,12] No correlation of USG signs of intraabdominal fluid and perforation were presently determined.…”