Effectiveness of pneumatic reduction of ileocolic intussusception in children.
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.
Menor
F
F
Department of Radiology, Hospital Infantil La Fe, Valencia, Spain.
Cortina
H
H
Marco
A
A
Olague
R
R
D000388:Air; D002675:Child, Preschool; D004733:Enema / Q000295:instrumentation; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000601:surgery / Q000628:therapy*; D007080:Ileocecal Valve / Q000000981:diagnostic imaging; D007223:Infant; D007443:Intussusception / Q000601:surgery / Q000628:therapy*; D008297:Male; D011859:Radiography; D012008:Recurrence