J Korean Surg Soc.
2008 Jan;74(1):65-70.
Change of the Clinical Aspects and Management of Childhood Intussusception
- Affiliations
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- 1Department of Surgery, Ewha Womans University School of Medicine, Seoul, Korea. kumchoi@ewha.ac.kr
Abstract
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PURPOSE & METHODS: Nonoperative reduction of childhood intussusception is the treatment of choice. However, few techniques of nonoperative reduction are available. When used, nonoperative reduction can be successfully completed by a radiologist. In this study, we analyzed 637 cases of childhood intussusception diagnosed and treated by ultrasound-guided saline enema reduction (UGSER) over nine years at Ewha Womans University Mokdong Hospital. We compared the results of 76 cases surgically treated after UGSER (US group) with 84 cases surgically treated after barium enema reduction in 1980s (BE group).
RESULTS
The success rate of the saline reduction was 88.1%. The risk factors associated with surgery were the patient's age, symptom duration and the type of intussusception. The rate of bowel resection was 32.9%. Patients less than six months old and a pathologic lead point (PLP) on the US were risk factors for bowel resection. There were no significant differences in age, gender and the number of PLPs between the US and BE groups. The number of patients with a spontaneous reduction was greater in the BE group and bowel perforation occurred only in the US group. The bowel resection rate was significantly higher in the US group. However, the median hospital stay was significantly shorter in the US group.
CONCLUSION
UGSER is reliable and safe in childhood intussusecption. Moreover, it has a high success rate and is easy to perform. The surgeon, without the need for a radiologist, performs this procedure from diagnosis to treatment. In addition, it might help avoid invasive surgery.
