An Easy, Safe and Effective Method for the Treatment of Intussusception: Ultrasound-Guided Hydrostatic Reduction

BACKGROUND: Intussusception is one of the important cause of intestinal obstruction in children.Hydrostatic reduction under ultrasound guidance is a popular treatment method of intussusception.We aimed to explain the demographic characteristics, treatment approaches in patients diagnosed with intussusception by ultrasound.
METHODS: Forty one patients diagnosed with intussusception by ultrasound between August 2011-May 2013 were retrospectively analyzed.Twenty-four of these patients which didn’t have any contraindication had ultrasound guided hydrostatic reduction as a treatment.
RESULTS: Twenty-four of the patients were male,17 of the patients were female where there was a 1.4: 1 ratio of male to female.The majority of the patients were between the ages of 6-24 months and 2-5 years.Mean age was 31,12±26,32(3-125) months.Patients were more frequently diagnosed in april and may.Seventeen patients which had clinical contraindication enrolled directly to surgery.In 20 of 24 patients who had ultrasound guided hydrostatic reduction, reduction was achieved.Three of them there was recurrence.In 2 of these patients successful reduction was achieved with second attempt.The remaining patient was enrolled to surgery.For these 24 patients hydrostatic reduction was performed for 26 times and in 22 of them success was achieved(84,6%).There was no procedure-related complications in patients.
CONCLUSÝON: Ultrasound guided hydrostatic reduction with high success rates and having no radiation risk,should be the first choice for therapeutic approach in children diagnosed with intussusception.

Ýnvajinasyonda Kolay, Güvenli ve Etkili Bir Tedavi Yöntemi: Ultrason Eþliðinde Hidrostatik Redüksiyon

AMAÇ: Ýnvajinasyon pediatrik yaþ grubunda önemli bir intestinal obstruksiyon nedenidir. Ultrason eþliðinde hidrostatik redüksiyon invajinasyon tedavisinde popüler bir yöntemdir. Bu çalýþmada ultrason ile invajinasyon tanýsý konan hastalarýn demografik özellikleri, tedavi yaklaþýmlarýný paylaþmayý amaçladýk.
GEREÇ VE YÖNTEM
Aðustos 2011-Mayýs 2013 tarihleri arasýnda ultrason ile invajinasyon tanýsý konan 41 olgu retrospektif olarak incelendi. Bu vakalardan klinik kontrendikasyonu bulunmayan 24’üne ultrason eþliðinde hidrostatik redüksiyon ile tedavi uygulandý.
BULGULAR
Olgularýn 24’ü erkek, 17’si kýz olup erkek kýz oraný 1.4: 1 olarak bulundu. Olgularýn çoðunluðu 6-24 ay ve 2-5 yaþ aralýðýnda saptandý. Yaþ ortalamasý 31,12±26,32 (3-125) ay idi. Olgular en sýk nisan ve mayýs aylarýnda saptandý. Klinik kontrendikasyonu bulunan 17 olgu doðrudan cerrahiye alýndý. Ultrason eþliðinde hidrostatik redüksiyon yapýlan 24 olgudan 20’sinde redüksiyon saðlandý. Bu olgularýn 3’ünde rekürrens saptandý. 3 olgudan 2 sine tekrar hidrostatik redüksiyon yapýlýp baþarý saðlandý. Diðer olgu cerrahiye alýndý. Toplamda 24 olguya 26 kez hidrostatik redüksiyon denenmiþ olup 22’sinde baþarý saðlandý (%84.6). Olgularda iþleme baðlý komplikasyon görülmedi.
SONUÇ
Ultrason eþliðinde hidrostatik redüksiyon, yüksek baþarý oranlarý ve radyasyon riskinin bulunmamasý nedeniyle invajinasyon tanýsý alan çocuklara tedavi yaklaþýmýnda ilk seçenek olmalýdýr.