Air enema for diagnosis and reduction of intussusception in children: clinical experience and fluoroscopy time correlation.
OBJECTIVE
The objective of this study was to correlate the fluoroscopy time with radiologic outcome in the pneumoreduction of intussusception in children.


METHODS
From September 1995 to December 1997, a prospective analysis of 181 cases of pediatric intussusception with pneumoreduction without sedation was done. A receiver operating characteristic curve of fluoroscopy time was drawn for correlation with radiologic outcome.


RESULTS
The overall success and failure rates of pneumoreduction were 84% and 16%, respectively. Three patients (1.6%) experienced colon perforation. The mean fluoroscopy time was 2.8 +/- 1.7 minutes in successful procedure and 4.9 +/- 2.8 minutes in failed procedures (P < 0.001). Analysis of the receiver operating characteristic curve of fluoroscopy time indicates that 4 minutes fluoroscopy time was a good critical point in differentiating successful and failed cases. In those 18 patients who had successful reduction with fluoroscopy times of more than 4 minutes, 4 patients had clinical symptoms for more than 1 day and 14 patients less than 1 day. One of those 4 patients required operation 1 day later because of peritonitis caused by necrosis of terminal ileum. Two patients had high fever in the next 2 days and recovered after antibiotic treatment.


CONCLUSIONS
Pneumoreduction is a good method in treatment of intussusception with high successful rate. Four minutes is the critical point of procedure. Reduction with greater than 4 minutes in those patients having illness more than 1 day might not benefit and have more complications.
First Department of Diagnostic Radiology, Chang Gung Medical Center, Chang Gung University, Tao-Yuan Hsien, Taiwan.
K W
KW
Lui
H F
HF
Wong
Y C
YC
Cheung
L C
LC
See
K K
KK
Ng
M S
MS
Kong
Y L
YL
Wan
D000388:Air; D002675:Child, Preschool; D004733:Enema; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007223:Infant; D007327:Insufflation / Q000379:methods*; D007443:Intussusception / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome