Ulus Travma Acil Cerrahi Derg. 2010; 16(4): 363-366

Çocukluk çaðý invajinasyon olgularýmýz ve pnömatik redüksiyon

Levent Cankorkmaz, Gökhan Köylüoðlu, Mehmet Þerif Arslan, Cengiz Güney
Cumhuriyet Üniversitesi Týp Fakültesi Çocuk Cerrahisi Anabilim Dalý, Sivas

AMAÇ
Ýnvajinasyon, proksimal baðýrsak segmentinin distal segment içine teleskopik olarak girmesidir. Çalýþmanýn amacý, invajinasyon olgularýmýzdan hareketle pnömatik redüksiyon deneyimlerimizi paylaþmaktýr.
GEREÇ VE YÖNTEM
Çocuk cerrahisi kliniðinde 1996-2008 tarihleri arasýnda invajinasyon tanýsýyla tedavi edilen 118 hastanýn dosyalarý, yaþ, cinsiyet, baþvuru ayý, bulgular, taný/tedavi yöntemleri, invajinasyon tipi ve sürükleyici noktalar açýsýndan yeniden incelenerek, bulgular tartýþýldý.
BULGULAR
Hastalarýn 76’sý (%64) erkek, 42’si (%36) kadýn, yaþ ortalamalarý 25±34 ay (daðýlým, 3-180 ay) idi. Baþvuruda en sýk yakýnmalar; karýn aðrýsý, huzursuzluk, kusma ve kanlý gaitaydý. Ýnvajinasyonlarýn 109’u ileokolik (%92,3), 7’si (%6) ileoileal, 2’si ise (%1,7) kolokolikti. Elli üç olgu (%45) cerrahi dýþý, geriye kalan olgular cerrahi yöntemle tedavi edildi. Hastalarýn hiçbirisinde mortalite görülmedi. Ameliyat edilen 65 hastadan 13’ünde sürükleyici nokta saptandý. Pnömatik redüksiyonun baþarý oraný %86 idi. Semptomlarýn baþlama süresi ve kanlý gaita pnömatik redüksiyonun baþarýsýný etkilemezken, yaþla baþarý oraný düþmüþtür.
SONUÇ
Ýnvajinasyona erken taný konulmasý durumunda, cerrahi dýþý yöntemlerle rahatlýkla tedavi edilebilen bir patolojidir. Çocuk yaþ grubunda perforasyon ve peritonit bulgularý olmayan tüm olgularda pnömatik redüksiyonun ilk seçenek olarak denenebileceðini düþünüyoruz.

Anahtar Kelimeler: Cerrahi dýþý tedavi, çocukluk çaðý; invajinasyon; pnömatik redüksiyon.

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Our childhood cases with intussusception and pneumatic reduction

Levent Cankorkmaz, Gökhan Köylüoðlu, Mehmet Þerif Arslan, Cengiz Güney
Cumhuriyet University Medicine School Department Of Pediatric Surgery Sivas, Turkey

BACKGROUND
Intussusception is defined as telescopic insertion of the terminal ileum in to the colon after the cecum and colon. The aim of this study was to present our experience in pneumatic reduction of intussusception.
METHODS
In our study, 118 intussusception cases treated between 1996 and 2008 were analyzed. Age, gender, admission time, diagnostic/treatment methods, types of intussusception including leading point, and postoperative complications were evaluated.
RESULTS
Of these patients, 76 (64%) were male and 42 (36%) were female. Mean age was 25±34 months (3-180 months). The most common clinical presentations were vomiting, abdominal pain/irritable crying and bloody stools. Intussusceptions were ileocolic in 109 (92.3%) patients, ileoileal in 7 (6%) patients, and colocolic in 2 (1.7%) patients. No mortality was noted. Fifty-three patients (45%) were treated by non-operative reduction whereas the remainder were treated surgically. Among 65 patients operated, 13 leading points were detected. Pneumatic reduction success rate was 86%. Age significantly reduced the pneumatic reduction success rate; however, the duration between the beginning of symptoms and hospital admission and bloody stool were not effective.
CONCLUSION
Intussusception can be treated by non-operative methods when diagnosed early. Our results suggest that pneumatic reduction of intussusception in the pediatric population should be considered as a first choice.

Keywords: Non-operative treatment, childhood; intussusception; pneumatic reduction.

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