Background
Intussusception is one of the most common paediatric emergencies, and an important cause of small bowel obstruction in children. Diagnosis and treatment of intussusception is a combined effort among the paediatrician, the paediatric radiologist, and the paediatric surgeon. For many years, open surgery has been its mode of treatment worldwide, but since few years, there is a paradigm shift in its management from immediate laparotomy after resuscitation to non-operative management.
Aim
To asses the USG-guided pneumatic reduction of intussusception in children.
Patients And Methods
A prospective case series study of 50 children admitted to a Tertiary care Hospital, at Hyderabad with a diagnosis of acute intussusception between May 2012 to April 2014 were included in the study. All children clinically suspected of having intussusception were evaluated by real time ultrasonography and those with positive findings were entered into the study.
Results
Out of 50 children enrolled in our study, 45 patients were subjected to pneumatic reduction and among the remaining 5 cases, 4 children had spontaneous reduction and one child was directly subjected to surgery due to septicaemia. Successful reduction was seen in 38 (84.4%) of the cases and failure of reduction was seen in 7 (15.55%) of cases.The cases with failed reductions were explored surgically. In two cases manual reduction was done and definitive lead point was noted in 5 cases, out of which two children had meckel’s diverticulum, two had gut associated lymphoma and one child had appendix.These results clearly state that pneumatic reduction of intussusception can fail only in the presence of lead points or in cases of loss of bowel vascularity.
