Intussusception: the accuracy of ultrasound-guided saline enema and the usefulness of a delayed attempt at reduction.
OBJECTIVE
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.
Department of Radiology, University Hospital 12 de Octubre, Madrid, Spain.
J
J
González-Spínola
G
G
Del Pozo
D
D
Tejedor
A
A
Blanco
D002648:Child; D002675:Child, Preschool; D003108:Colonic Diseases / Q000000981:diagnostic imaging / Q000628:therapy; D004733:Enema; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000000981:diagnostic imaging / Q000628:therapy; D007080:Ileocecal Valve / Q000000981:diagnostic imaging; D007223:Infant; D007421:Intestine, Small / Q000000981:diagnostic imaging; D007443:Intussusception / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D008297:Male; D012008:Recurrence; D012965:Sodium Chloride / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography
D012965:Sodium Chloride