Abstract
Aim: Intussusception is a major cause of childhood acute intestinal obstructions which are observed more frequently in infants. The majority of patients were treated by non-surgical methods. In this study, it was aimed to carry out retrospective evaluation of the results of the hydrostatic reduction with fluoroscopy in childhood intussusception cases. Method: The 24 patients, who were diagnosed with intussusception retrospectively between January 2013 and May 2015, were included in the study. In the study, hydrostatic reduction with the fluoroscopy process was applied to 23 intussusception patients in an operating room. Results: The 14 of the cases were male (58.3%) and 10 of them were female (41.7%) with the average age of 51.5±36.11 months. The 15 (62.5%) of the patients were in the age range of 2-5 years. While 100% of the cases had abdominal pain and vomiting, 25% of them experienced rectal bleeding. Ultrasonography results indicated target sing image in all cases. One of the patients was directly undergone surgical intervention due to the clinical contraindications. The process was performed successfully in the 20 patients (86.9%) out of 23 patients who were undergone hydrostatic reduction. Recurrence was observed in 2 patients and the hydrostatic reduction was performed in these patients successfully. Conclusions: The hydrostatic reduction with the fluoroscopy is an easy, effective and reliable method in accurately selected clinical pediatric cases with the diagnosis of intussusception. Although considering the increment in complication rates in older pediatric patients, the initial approach for intussusception treatment should be nonsurgical methods
References
- Sigmound EH., Daneman A. Intussusceptıon. In: Grosfeld JL., O’Neil JA., Fonkalsrud EW. Eds: Pediatric Surgery, 6nd ed., Philadelphia: Mosby Year Book Inc., 2006:1313-41.
- Bines J. Intussusception and rotavirus vaccine. Vaccine 2006;24(18):3772-6.
- Daneman A., Navarro O. Intussusception: the debate endures. Pediatr Radiol 2005;35(1):95–6.
- Herusu-shuppan. Evidence-based Guidelines for the Management of Intussusception in Children. In: Guideline Committee of the Japanese Society of Emergency Medicine, editors. Japanese Society of Emergency Pediatrics. Tokyo:2012.p.10–7.
- Navarro O., Daneman A. Intussusception Part 3: diagnosis and management of those with an identifiable or predisposing cause and those that reduce spontaneously. Pediatr Radiol 2004;34(4):305-12.
- Blakelock RT., Beasley SW. The clinical implications of non-idiopathic intussusception. Pediatr Surg Int 1998;14(3):163-7.
- Ein SH., Alton D., Palder SB., Shandling B., Stringer D. Intussusception in the 1990s: has 25 years made a difference? Pediatr. Surg. Int. 1997;12(5-6):374–6.
- Rafensperger J. Intussusception. In: Rafensperger J. Eds: Swenson’s Pediatric Surgery, 5nd ed., Norwalk (Conn): Appleton & Lange 2007:221-9.
- Tander B., Baskin D., Candan M., Başak M., Bankoğlu M. Ultrasonografi eşliğinde serum fizyolojik ile invajinasyon redüksiyonu ve operatif tedavi ile karşılaştırma. Ulus Travma Acil Cerrahi Derg 2007;13(4):288-93.
- Yoon CH., Kim HJ., Goo HW. Intussusception in children; US-guided pneumatic reduction-initial experience. Radiology 2001;218(1):85-8.
- Vidmar D., Perović AV. Sonographycally guided hydrostatic reduction of childhood intussusception . Radiol Oncol 2004;34(8):269-73.
- Young D. Intussusception. In: O'Neil JA., Rowe MI., Grosfeld JL. Eds: Pediatric surgery, 5nd Ed., St. Louis: Mosby-Year Book Inc., 1998:1185-98.
- Yang CM., Hsu HY., Tsao PN., Chang MH., Lin FY. Recurrence of intussusception in childhood. Acta Paediatr Taiwan 2001;42(3):158-61.
- Krishnakumar., Hameed S., Umamaheshwari. Ultrasound guided hydrostatic reduction in the management of intussusception. Indian J Pediatr 2006;73(3):217-20.
- -
- Hesse Afua AJ., Abantanga FA., Lakhoo K. Intussusception. In: Ameh EA., Bickler SW., Lakhoo K., Nwomeh BC., Poenaru D. Eds: Paediatric surgery: a comprehensive text for Africa, Seattle: 2011:404-12.
- -
- Di Fiore JW. Intussusception. Semin Pediatr Surg 1999;8(4):14-220.
- Kruatrachue A., Wongtapradit L., Nithipanya N., Ratanaprakarn W. Result of air enema reduction in 737 cases of intussusception. J Med Assoc Thai 2011;94(3):22-6.
- Stringer DA., Ein SH. Pneumatic reduction: advantages, risks and indications. Pediatr Radiol 1990;20(6):475-7.
- Meyer JS., Dangman BC., Buonomo C., Berlin JA. Air and liquid contrast agents in the management of intussusception: a controlled, randomized trial. Radiology 1993;188(2):507-11.
- Wang GD. Liu SJ. Enema reduction of intussusception by hydrostatic pressure under ultrasound guidance : a report of 377 cases. J Pediatr Surg 1988;23(9):814-18.
- Gonzáles-Spínola J., Del Pozo G., Tejedor D., Blanco A. Intussusception: the acurracy of ultrasound-guided saline enema and the usefulness of delayed attempt at reduction. J Pediatr Surg 1999;34(6):1016-20.
- Digant SM., Rucha S., Eke D. Ultrasound guided reduction of an ileocolic intussusception by a hydrostatic method by using normal saline enema in paediatric patients: a study of 30 cases. J Clin Diagn Res 2012;6(10):1722-5.
Çocukluk çağı invajinasyon olgularında floroskopi eşliğinde uygulanan hidrostatik redüksiyon sonuçları
Abstract
Amaç: İnvajinasyon, çoğunlukla infantlarda olmak üzere çocukluk çağı akut barsak tıkanıklarının önemli bir sebebidir. Hastaların büyük çoğunluğu ameliyat dışı yöntemler ile tedavi edilebilmektedir. Bu çalışmada çocukluk çağı invajinasyon olgularında floroskopi eşliğinde uygulanan hidrostatik redüksiyon sonuçlarının değerlendirilmesi amaçlanmıştır. Yöntem: Çalışmaya Ocak 2013-Mayıs 2015 tarihleri arasında invajinasyon tanısı almış 24 olgu dahil edildi. Olguların 23’üne ameliyathane koşullarında floroskopi eşliğinde hidrostatik redüksiyon işlemi uygulanmıştır. Çalışma bu olguların hasta kayıtlarının geriye doğru incelenmesi ile yapılmıştır. Bulgular: Olguların 14’ü erkek (%58.3), 10’u kız (%41.7) olup, yaş ortalaması 51.5±36.11 ay idi. Olguların 15’i (%62.5) 2-5 yaş aralığında idi. Olguların %100’ünde karın ağrısı ve kusma görülürken %25’inde rektal kanama mevcuttu. Olguların tamamında ultrasonografide hedef tahtası (target sing) görünümü mevcuttu. Bir hasta klinik kontrendikasyon nedeni ile doğrudan cerrahiye alındı. Hidrostatik redüksiyon uygulanan 23 hastanın 20’sinde (%86.9) işlem başarılı şekilde tamamlandı. Çalışmada 2 olguda invajinasyon tekrarı görüldü ve bu iki olguda da hidrostatik redüksiyon başarılı şekilde uyguladı.Sonuç: Çocuk yaş grubunda invajinasyon tanısı almış, klinik olarak doğru seçilmiş olgularda floroskopi eşliğinde hidrostatik redüksiyon basit, etkili ve güvenilir bir yöntemdir. İleri yaştaki çocuk hastalar içinde artan komplikasyon oranları göz önünde bulundurularak, invajinasyonda ilk tedavi yaklaşımı cerrahi dışı yöntemler olmalıdır.
References
- Sigmound EH., Daneman A. Intussusceptıon. In: Grosfeld JL., O’Neil JA., Fonkalsrud EW. Eds: Pediatric Surgery, 6nd ed., Philadelphia: Mosby Year Book Inc., 2006:1313-41.
- Bines J. Intussusception and rotavirus vaccine. Vaccine 2006;24(18):3772-6.
- Daneman A., Navarro O. Intussusception: the debate endures. Pediatr Radiol 2005;35(1):95–6.
- Herusu-shuppan. Evidence-based Guidelines for the Management of Intussusception in Children. In: Guideline Committee of the Japanese Society of Emergency Medicine, editors. Japanese Society of Emergency Pediatrics. Tokyo:2012.p.10–7.
- Navarro O., Daneman A. Intussusception Part 3: diagnosis and management of those with an identifiable or predisposing cause and those that reduce spontaneously. Pediatr Radiol 2004;34(4):305-12.
- Blakelock RT., Beasley SW. The clinical implications of non-idiopathic intussusception. Pediatr Surg Int 1998;14(3):163-7.
- Ein SH., Alton D., Palder SB., Shandling B., Stringer D. Intussusception in the 1990s: has 25 years made a difference? Pediatr. Surg. Int. 1997;12(5-6):374–6.
- Rafensperger J. Intussusception. In: Rafensperger J. Eds: Swenson’s Pediatric Surgery, 5nd ed., Norwalk (Conn): Appleton & Lange 2007:221-9.
- Tander B., Baskin D., Candan M., Başak M., Bankoğlu M. Ultrasonografi eşliğinde serum fizyolojik ile invajinasyon redüksiyonu ve operatif tedavi ile karşılaştırma. Ulus Travma Acil Cerrahi Derg 2007;13(4):288-93.
- Yoon CH., Kim HJ., Goo HW. Intussusception in children; US-guided pneumatic reduction-initial experience. Radiology 2001;218(1):85-8.
- Vidmar D., Perović AV. Sonographycally guided hydrostatic reduction of childhood intussusception . Radiol Oncol 2004;34(8):269-73.
- Young D. Intussusception. In: O'Neil JA., Rowe MI., Grosfeld JL. Eds: Pediatric surgery, 5nd Ed., St. Louis: Mosby-Year Book Inc., 1998:1185-98.
- Yang CM., Hsu HY., Tsao PN., Chang MH., Lin FY. Recurrence of intussusception in childhood. Acta Paediatr Taiwan 2001;42(3):158-61.
- Krishnakumar., Hameed S., Umamaheshwari. Ultrasound guided hydrostatic reduction in the management of intussusception. Indian J Pediatr 2006;73(3):217-20.
- -
- Hesse Afua AJ., Abantanga FA., Lakhoo K. Intussusception. In: Ameh EA., Bickler SW., Lakhoo K., Nwomeh BC., Poenaru D. Eds: Paediatric surgery: a comprehensive text for Africa, Seattle: 2011:404-12.
- -
- Di Fiore JW. Intussusception. Semin Pediatr Surg 1999;8(4):14-220.
- Kruatrachue A., Wongtapradit L., Nithipanya N., Ratanaprakarn W. Result of air enema reduction in 737 cases of intussusception. J Med Assoc Thai 2011;94(3):22-6.
- Stringer DA., Ein SH. Pneumatic reduction: advantages, risks and indications. Pediatr Radiol 1990;20(6):475-7.
- Meyer JS., Dangman BC., Buonomo C., Berlin JA. Air and liquid contrast agents in the management of intussusception: a controlled, randomized trial. Radiology 1993;188(2):507-11.
- Wang GD. Liu SJ. Enema reduction of intussusception by hydrostatic pressure under ultrasound guidance : a report of 377 cases. J Pediatr Surg 1988;23(9):814-18.
- Gonzáles-Spínola J., Del Pozo G., Tejedor D., Blanco A. Intussusception: the acurracy of ultrasound-guided saline enema and the usefulness of delayed attempt at reduction. J Pediatr Surg 1999;34(6):1016-20.
- Digant SM., Rucha S., Eke D. Ultrasound guided reduction of an ileocolic intussusception by a hydrostatic method by using normal saline enema in paediatric patients: a study of 30 cases. J Clin Diagn Res 2012;6(10):1722-5.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Articles |
| Authors | |
| Publication Date | October 15, 2015 |
| Submission Date | June 15, 2015 |
| Published in Issue | Year 2014 Volume: 7 Issue: 3 |
Cite
MEU Journal of Health Sciences Assoc was began to the publishing process in 2008 under the supervision of Assoc. Prof. Gönül Aslan, Editor-in-Chief, and affiliated to Mersin University Institute of Health Sciences. In March 2015, Prof. Dr. Caferi Tayyar Şaşmaz undertook the Editor-in Chief position and since then he has been in charge.
Publishing in three issues per year (April - August - December), it is a multisectoral refereed scientific journal. In addition to research articles, scientific articles such as reviews, case reports and letters to the editor are published in the journal. Our journal, which has been published via e-mail since its inception, has been published both online and in print. Following the Participation Agreement signed with TÜBİTAK-ULAKBİM Dergi Park in April 2015, it has started to accept and evaluate online publications.
Mersin University Journal of Health Sciences have been indexed by Turkey Citation Index since November 16, 2011.
Mersin University Journal of Health Sciences have been indexed by ULAKBIM Medical Database from the first issue of 2016.
Mersin University Journal of Health Sciences have been indexed by DOAJ since October 02, 2019.
Article Publishing Charge Policy: Our journal has adopted an open access policy and there is no fee for article application, evaluation, and publication in our journal. All the articles published in our journal can be accessed from the Archive free of charge.
This work is licensed with Attribution-NonCommercial 4.0 International.