Intussusception in Children - Pearls in Nonsurgical Management
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 4
Abstract
Intussusception is one of the most common abdominal emergencies affecting children less than 2 years with tailored treatment bystanding the mortality rate to less than 1%. Our study included children with intussusception with all of them undergoing colour doppler of the involved bowel and definitive management was initiated by ultrasound guided hydrostatic reduction or surgery. The predictive indicators for hydrostatic reduction and the usefulness of Doppler for successful reduction was evaluated. Of the 75 children , 42 presented within 24 hours of onset of symptoms (56%), 26 within 48 hours ( 34%) and 7 after 72 hours (10%). Ultrasound revealed pathological lead point in 8 cases pre-operatively (73%) and free fluid in 9 (90%) , with 16 (94.11%) of them ending up in surgery. Doppler sensitivity in identifying the viability of the involved bowel was 98.7% . Radiological guided reduction had 90% success in children who presented within 24 hours . Earlier presentation and good Doppler flow had a better chance of hydrostatic reduction with delayed presentations, pathological lead points and presence of free fluid invariably ending in surgery. Doppler plays a major role to prempt treatment modality and hence to be included as a part of routine workup.
Authors and Affiliations
Rengarajan R, Venkatesa Mohan N, Alex Jc, Raghul M
Keywords
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