Intermittent sonographic guidance in air enemas for reduction of childhood intussusception.
OBJECTIVE
The purpose of this study was to prospectively assess the value of intermittent sonographic guidance in nonsurgical air reduction of childhood intussusception.


METHODS
The study group included 86 consecutive childhood intussusceptions confirmed on sonography for which we designed an air enema. With intermittent sonographic guidance of our own method, air was gradually injected to the initial intracolonic pressure of 60 mm Hg, which we attempted for 30 seconds on the initial attempt. If the air enema reduction attempts were not successful at a given pressure setting, we repeated the technique at each pressure setting upgraded by increments of 20 mm Hg up to 120 mm Hg. Surgery was performed when even repeated reduction attempts at the maximum intracolonic pressure of 120 mm Hg were unsuccessful. We calculated the successful reduction rate for the intussusceptions at each pressure setting.


RESULTS
The overall success rate of sonographically guided air enema reductions was 95% (82/86). The success rates of air enema reductions at 60, 80, 100, and 120 mm Hg showed progressive increases of 53% (42/86), 67% (58/86), 78% (67/86), and 95% (82/86), respectively, with no immediate recurrence and no gross perforation.


CONCLUSIONS
The use of intermittent sonographic guidance in air enemas is thought to help safely increase successful reductions of childhood intussusception even with sufficient air enema attempts.
Lee
Jong Hwa
JH
Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, 290-3 Cheonha-Dong, Ulsan 682-714, Korea. jhlee@uuh.ulsan.kr
Choi
Seong Hoon
SH
Jeong
Yoong Ki
YK
Kwon
Woon Jung
WJ
Jeong
Ae Kyoung
AK
Kang
Byeong Seong
BS
Shin
Shang Hun
SH
D000388:Air; D002675:Child, Preschool; D004733:Enema / Q000379:methods*; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D007223:Infant; D007443:Intussusception / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional