The role of steroids in children with multiple recurrences of intussusception

Lopez, Robert; Beasley, Spencer W.; Blakelock, R. T.; Maoate, Kiki; McBride, Craig A.; Slade, C. Lawrence; Day, Andrew S.; King, Sebastian K.

doi:10.1111/j.1440-1754.2011.02406.x

Cited by 4 publications

(3 citation statements)

References 6 publications

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“…Yet, it is surprising that has been no mention of this therapeutic modality in the current literature. 10,[12][13][14] In our present study, early recurrence of intussusception was noted to be much less in the Dexamethasone group, in comparison to the non-Dexamethasone group, which is in concordance to the study by Essa et al who evaluated the role of Dexamethasone in decreasing early recurrent intussusception and reported a higher incidence of early recurrent intussusception in the control group (14%) compared to the treated group (2.5%). 8 In a study by Long et al who compared contrast media, imaging modalities, pharmacologic adjuvants, protocols for delayed repeated enema, surgical approaches and other curative techniques for intussusception management, it has been reported that dexamethasone intramuscularly as an adjuvant therapy may reduce intussusception recurrence after air or liquid enema and is preferred as a medical measure.…”

Section: Discussionsupporting

confidence: 92%

“…1,8 -12 The first successful surgical reduction in a paediatric patient was performed in 1871 by Jonathan Hutchinson. 12,13 By 1905, Harald Hirschsprung had accumulated 107 cases of hydrostatic enema reduction, nevertheless the treatment of intussusception in children was predominantly surgical until the mid-twentieth century. 2,8,9 The classical triad of intussusception are abdominal pain, palpable abdominal mass, and red currant jelly stools is quite rare and present in less than 15% of cases.…”

Section: Discussionmentioning

confidence: 99%

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Role of Dexamethasone as an adjuvant in the treatment of intussusception: A prospective study

Raja

Gajanthody

Deep

et al. 2023

MRAJ

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Background: Intussusception is one of the most commonly encountered abdominal emergencies in children for which the preferred treatment modality has always been non operative hydrostatic reduction. Recurrence is a common concern after a successful hydrostatic reduction. Adjuvant treatment with pharmacological agents have been considered to reduce chances of recurrence. Aim: The study was conducted to examine the role of dexamethasone in decreasing early recurrent intussusception. Materials and methods: A prospective cohort study was conducted in a tertiary care center from June 2018- June 2022 on 51 pediatric patients, admitted with intussusception and divided into a dexamethasone and non-dexamethasone group. Data was collected regarding demography, rate of recurrences, duration of hospital stay, surgery performed if any including the intraoperative findings and associated complications. The level of significance was set at 5%. SPSS version 27 was used to perform the statistical analysis. Result: After ultrasound-guided hydrostatic reduction, the dexamethasone group showed significant reduction in recurrence, compared to the non-dexamethasone group. In this study, 7 cases showed recurrence despite three attempts of hydrostatic reduction and intraoperatively noted to have a pathological lead point. Conclusion: Dexamethasone is one of the greatest discoveries of the 20th century with its vast use in multiple diseases. The use of dexamethasone during hydrostatic reduction of intussusception in a pediatric population makes it a wonderful drug with remarkable results and patient outcome.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Role of Dexamethasone as an adjuvant in the treatment of intussusception: A prospective study

Raja

Gajanthody

Deep

et al. 2023

MRAJ

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“…ILH, a result of enhanced immune response to foreign antigens such as virus, bacteria and food components in young children [ 11 ], is a rare cause for IR [ 6 ]. A few case reports have shown that corticosteroids are effective for the treatment of ILH-induced IR in children [ 12 – 14 ]. In contrast, we observed that IR was not responsive to dexamethasone.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of recurrent intussusception induced by intestinal lymphoid hyperplasia in a child: is bowel resection always necessary? A case report

Wang

et al. 2022

BMC Surg

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Background Intussusception recurrence (IR) induced by intestinal lymphoid hyperplasia (ILH) in children is rare, and surgical treatment is the final resort if IR is refractory to medications and non-surgical interventions. To date, only a few case reports have described surgical management of ILH-induced IR in children, all involving bowel resection regardless of whether there are bowel necrosis and perforation. Case presentation A 2-year-old boy was transferred to our department due to IR. His main complaint was abdominal pain. Color Doppler ultrasound confirmed ileocecal intussusception while no other abnormalities were found. A final diagnosis of IR with unknown causes was made. Repeated saline enema reductions and dexamethasone failed to cure the IR. Laparotomy was eventually performed after almost 10 episodes of IR. Intraoperatively, distal ileum thickening with palpable masses without bowel necrosis and perforation was noted. ILH was suspected and a biopsy of the affected intestine was performed. Histopathological analysis confirmed ILH. The intussusception was manually reduced, the terminal ileum and the ileocecal junction were fixed to the paralleled ascending colon and the posterior peritoneum respectively, and no bowel resection was performed. The postoperative recovery was uneventful and no IR was observed during over 5 years of follow-up. Conclusions As far as we are aware, this is the first report of successful surgical treatment of ILH-induced pediatric IR without bowel resection in a child. Our experience suggests bowel resection may be unnecessary if bowel necrosis and perforation are absent.

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The role of dexamethasone in decreasing early recurrence of acute intussusception in children: A retrospective study

Efrati

Klin

Kozer

et al. 2017

Journal of Pediatric Surgery

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The role of steroids in children with multiple recurrences of intussusception

Cited by 4 publications

References 6 publications

Role of Dexamethasone as an adjuvant in the treatment of intussusception: A prospective study

Role of Dexamethasone as an adjuvant in the treatment of intussusception: A prospective study

Surgical treatment of recurrent intussusception induced by intestinal lymphoid hyperplasia in a child: is bowel resection always necessary? A case report

The role of dexamethasone in decreasing early recurrence of acute intussusception in children: A retrospective study

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