Ultrasound-guided Hartmann's solution enema: first-choice procedure for reducing idiopathic intussusception.
OBJECTIVE
This study was undertaken to compare the effectiveness of ultrasound-guided Hartmann's solution enema (US-E) and radiological liquid enema (RX-E) in reducing idiopathic ileocecocolic intussusceptions in relation to patient age and symptom duration.


METHODS
The study group consisted of 42 patients with idiopathic ileocecocolic intussusception treated with US-E (20 patients) or RX-E (23 patients), with one patient undergoing both procedures owing to recurrence. Patients were divided into subgroups according to age (<6 months, 6-12 months, >12 months) and symptom duration (<12 h, 12-24 h, >24 h).


RESULTS
Complete reduction was achieved in 15/20 patients treated with US-E (75%) and in 10/23 treated with RX-E (43.5%) (p=ns). Recurrence was observed in 1/20 US-E and 0/23 RX-E (p=ns) patients. No complications were encountered. US-E had a significantly higher success rate than RX-E in patients >12 months (p=0.0063) and with symptom duration >24 h (p=0.0361). No differences were found in the other subgroups (p=ns).


CONCLUSIONS
US-E and RX-E are procedures of comparable value and safety in reducing idiopathic intussusception. US-E seems to be more effective in patients >12 months or with symptom duration >24 h. As US-E avoids radiation exposure, it should be considered the first-choice procedure for reducing idiopathic ileocecocolic intussusception, particularly in these two subgroups of patients.
Unità Operativa di Chirurgia Pediatrica G. d'Annunzio, University of Chieti, Spirito Santo Hospital of Pescara, Via Fonte Romana 8, 65124, Pescara, Italy. dacia.direnzo@poste.it
D
D
Di Renzo
M
M
Colangelo
G
G
Lauriti
F
F
De Girolamo
A
A
Persico
P
P
Lelli Chiesa
D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000008:administration & dosage; D003974:Diatrizoate Meglumine / Q000008:administration & dosage; D004733:Enema / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D006874:Hydrostatic Pressure; D007077:Ileal Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D007223:Infant; D007443:Intussusception / Q000000981:diagnostic imaging / Q000628:therapy*; D007552:Isotonic Solutions / Q000627:therapeutic use*; D008297:Male; D015641:Radiography, Interventional; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D003287:Contrast Media; D007552:Isotonic Solutions; D003974:Diatrizoate Meglumine