Intussusception: The accuracy of ultrasound-guided saline enema and the usefulness of a delayed attempt at reduction

• Published in: Journal of pediatric surgery Vol. 34; no. 6; pp. 1016 - 1020
• Main Authors: González-Spínola, Javier, Del Pozo, Gloria, Tejedor, Daniel, Blanco, Ana
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01-06-1999; Elsevier
• Subjects: Biological and medical sciences; Child; Child, Preschool; Colonic Diseases - diagnostic imaging; Colonic Diseases - therapy; Enema; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Ileal Diseases - diagnostic imaging; Ileal Diseases - therapy; Ileocecal Valve - diagnostic imaging; Infant; Intestine, Small - diagnostic imaging; Intussusception - diagnostic imaging; Intussusception - surgery; Intussusception - therapy; Male; Medical sciences; Other diseases. Semiology; Recurrence; Sodium Chloride - therapeutic use; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Time Factors; Treatment Outcome; Ultrasonography; ultrasound guidance; intussusception; saline enema; Ultrasonography; Human; Treatment efficiency; Intussusception; Gut; Infant; Time lag; Enema; Guidance; Echography; Digestive diseases; Intestinal disease; Child; Saline solution
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/S0022-3468(99)90781-9

Background/Purpose:
The aim of this study was to evaluate the therapeutic value of ultrasound (US)-guided saline enema for intussusception and the usefulness of a delayed attempt after at least 30 minutes when reduction has not been complete.
Methods:
One hundred ninety-five cases of intussusception were diagnosed with ultrasonography. US-guided saline hydrostatic reduction was performed in 194 with an additional attempt after at least 30 minutes in those cases in which only partial resolution had been achieved. The method was changed (the volume of the reservoir bag and the caliber of the catheter were increased) so we analyze two different periods; 85 cases are included in the first period and 110 in the second.
Results:
The global rate of successful reduction was 81.9% (159 of 194 cases), and it raised to 88.2% (97 of 110 cases) in the second period. In 15.5% cases (30 of 194) reduction was achieved in a delayed attempt at least 30 minutes after the initial partial resolution. The rate of recurrence was 9.7%. No perforation was seen.
Conclusions:
The accuracy of US-guided saline enema in achieving intussusception reduction is high, similar to other methods, avoiding radiation exposure. A delayed attempt after a period of rest increases the rate of reductions.