A Comparison of Hydrostatic Reduction in Children with Intussusception versus Surgery: Single Center Experience

Background Intussusception is the commonest cause of bowel obstruction in infancy and childhood. Early diagnosis and effective management have reduced its morbidity and mortality in developed countries (1). Non-surgical reduction remains the first line treatment of choice for intussusception (2). The major complication of air enema reduction is bowel perforation and portal venous gas (3). Objective In recent years several techniques have been recommended for intussusception treatment. In this study, an evaluation was made of intussusception cases that presented at our clinic and had reduction applied together with saline under ultrasonography (USG) and cases, which were surgically treated. Aim of the work Our aim of this study is to evaluate the results of hydrostatic reduction under ultrasound guided and to compare the results with patients treated by surgery for management of intussusception. Patient and methods A retrospective study was done of the records of 100 cases treated for a diagnosis of intussusception between April 2011 and April 2013, in department of pediatric surgery, Zagazig university hospital. Patients were evaluated demographics, clinical presentation, management strategy, during the hospitalization and outcome. Results This study include 100 patients diagnosed with intussusception, 60 male and 40 female, the age ranged between 1month and 7 years old. Ultrasound was applied for all patients as a part of diagnosis. Hydrostatic reduction under ultrasound guide was applied to 50 patients, successful hydrostatic reduction was seen in 30 patients and unsuccessful hydrostatic reduction was seen in 20 patients which admitted for surgery, we didnt do another chance of hydrostatic reduction for unsuccessful patients, open surgery was done for 70 patients, during surgery we found ileocolic intussusception in 40 patients, ileoileal in20 patients, and colocolic intussusception in 10 patients. Leading point of intussusception was seen in 22 patients, Mikles diverticulum in 10 patients, polyp in 5 patients and lymphoma in 7 patients. Manual reduction was done in 40 patients and resection anastomosis was done in 30 patients. No mortality in any case. Conclusion Ultrasound guided hydrostatic reduction of intussusception is a safe technique which reduces duration of hospitalization and treatment costs.