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Sonographic guided hydrostatic saline enema reduction of childhood intussusception: a prospective study
Authors:Ademola Olusegun Talabi  Olusola Comfort Famurewa  Kayode Taiwo Bamigbola  Oludayo Adedapo Sowande  Babalola Ishmael Afolabi  Olusanya Adejuyigbe
Institution:1.Department of Surgery,Obafemi Awolowo University,Ile-Ife,Nigeria;2.Department of Radiology,Obafemi Awolowo University,Ile-Ife,Nigeria;3.Department of Surgery, Federal Medical Centre,Owo,Nigeria
Abstract:

Background

The management of childhood intussusception in our sub-region is still via surgical intervention. Currently, the gold standard of treatment is non-operative reduction. We sought to assess the suitability of hydrostatic (saline) reduction of intussusception in children in our institution.

Materials and methods

A prospective study was conducted between January 2016 and June 2017 in all children with ultrasound confirmed intussusception at a tertiary teaching hospital in Nigeria. All children excluding those with signs of peritonitis, bowel gangrene and intestinal prolapse were selected for ultrasound-guided hydrostatic reduction (USGHR). We allowed a maximum of three attempts at reduction.

Results

The age range was 3 months to 48 months with a mean of 10.8?±?9.1 months. Forty percent (N?=?18) presented after 24 h of onset of symptoms. The success rate of hydrostatic reduction with saline enema was 84.4% (N?=?38). Two (4.4%) perforations occurred during the procedure. Three (7.5%) patients had recurrent intussusception within six months. The duration of symptoms greater than 24 h, age and sex of patients did not influence successful reduction p?>?0.05. The duration of admission between those who had successful non-operative reduction and those who subsequently had operative reduction and or resection attained statistical significant difference, p?=?0.001. There was no mortality. We achieved a 68% decrease in the operative reduction of intussusception using USGHR as the primary modality of treatment.

Conclusion

Our study found out that USGHR is a suitable alternative for the treatment of childhood intussusception.
Keywords:
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