Idiopathic intussusception: the role of laparoscopy.
BACKGROUND
The use of a barium enema affords both diagnostic confirmation and a chance for nonsurgical complete reduction of the intussusception, which must be proven by adequate reflux of barium into the distal ileum. If this does not occur, it is assumed that the intussusception has not been reduced, and the infant is taken straight to the operating room for laparotomy and surgical treatment. The aim of this study is to limit unnecessary surgical explorations by the diagnostic and the therapeutic policy of laparoscopy with assisted hydrostatic saline reduction under general anesthesia.


METHODS
Over a period of 3 years, 90 patients with intussusception were treated. Twenty patients in whom hydrostatic reduction was contraindicated were treated initially by surgery. In the remaining 70 patients, hydrostatic reduction was successful in 50 (71%), and laparoscopy was performed in 20 patients before laparotomy. Hydrostatic saline reduction was used when there was failure of reduction seen by laparoscopy.


RESULTS
In 20 patients, laparoscopy showed reduction of intussusception in eight patients (40%), and saline hydrostatic reduction was successful in six patients (30%), with failure of reduction in six patients (30%) necessitating laparotomy.


CONCLUSIONS
The use of laparoscopy for diagnosis of failure of reduction of intussusception and the hydrostatic reduction by saline enema during laparoscopy saved 14 patients from unnecessary laparotomy.
Hay
S A
SA
Pediatric Surgery Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.
Kabesh
A A
AA
Soliman
H A
HA
Abdelrahman
A H
AH
D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis / Q000628:therapy*; D007223:Infant; D007443:Intussusception / Q000175:diagnosis / Q000628:therapy*; D010535:Laparoscopy; D008297:Male; D012965:Sodium Chloride
D012965:Sodium Chloride