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Title:Sonographycally guided hydrostatic reduction of childhood intussusception
Authors:ID Vidmar, Dubravka (Author)
ID Višnar-Perovič, Alenka (Author)
Files:.pdf PDF - Presentation file, download (203,04 KB)
MD5: 314D22A1589E1DEA5D905ACD28A81059
 
Language:English
Typology:1.01 - Original Scientific Article
Organization:Logo OI - Institute of Oncology
Abstract:Background. Intussusception is the most common cause of bowel obstruction in children under two years of age. The proximal part of the bowel and its mesentery (the intussusceptum) enter within that part immediately beneath it (the intussuscipiens). Being pulled by peristalsis the mesenterial vessels getcompressed which result in ishaemia of the bowel wall. Most intussusceptions are ileocolic. The diagnosis can be confirmed by a contrast enema or ultrasound. Sonography demonstrates a so-called target-within-a-target patfern (in cross-section) with thickened edematous bowel wall with or without vascularisation and prestenotic dilatation with increased peristalsis. Therapeutic reduction can be attempted by a contrast enema (following diagnostic procedure) or by air, both under fluoroscopic monitoring, or by normal saline under sonographic guidance. Patients and methods. We detected sonographically intussusception in three girls of 15, 16 and 18 months having typical clinical signs. We continued with hydrostatic reduction under the sonographic guidance. The reduction was attempted with a saline enema on body-temperature, introduced by the equipment for contrast enema. The bottle o f normal saline was hung up 1 m over the examination desk.We needed few liters of saline to replace lost liquids due to the incomplete occlusion of rectum. Meanwhile we monitored the moving of the intussusceptum back into the proximal direction. Criteria for a succesful reduction were the disappearance of the intussusceptum and the passage of fluid through the ileocecal valve. Results. Success was proven in all three girls. No complications occured and the pain relieved immediately after the procedure. There were no signs of intussusception on sonography after 2 and 12hours. We saw a slightly edematous wall of ileocecal valve and terminal ileum. Due to their exellent clinical conditions they were discharged from hospital after a second sonography. (Abstract truncated at 2000 characters).
Publication status:Published
Publication version:Version of Record
Publication date:01.01.2004
Publisher:Association of Radiology and Oncology
Year of publishing:2004
Number of pages:str. 269-273
Numbering:Letn. 38, št. 4
Source:Ljubljana
PID:20.500.12556/DiRROS-18155 New window
UDC:616-006
ISSN on article:1318-2099
COBISS.SI-ID:19024345 New window
Copyright:by Authors
Note:BSDOCID112275;
Publication date in DiRROS:13.02.2024
Views:693
Downloads:152
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VIDMAR, Dubravka and VIŠNAR-PEROVIČ, Alenka, 2004, Sonographycally guided hydrostatic reduction of childhood intussusception. Radiology and oncology [online]. 2004. Vol. 38, no. 4, p. 269–273. [Accessed 10 April 2025]. Retrieved from: https://dirros.openscience.si/IzpisGradiva.php?lang=eng&id=18155
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Record is a part of a journal

Title:Radiology and oncology
Shortened title:Radiol. oncol.
Publisher:Slovenian Medical Society - Section of Radiology, Croatian Medical Association - Croatian Society of Radiology
ISSN:1318-2099
COBISS.SI-ID:32649472 New window

Secondary language

Language:Slovenian
Title:Dezinvaginacija s hidrokolonsonografijo pri otroku
Abstract:Izhodišča. Invaginacija je najpogostejši vzrok črevesne obstrukcije pri otrocih, mlajših od dveh let. Proksimalni del črevesa in njegov mezenterij (intususceptum) se uvihata v distalni del (intususcipiens), nato ju peristaltika vleče naprej, pri čemer se komprimira mezenterialno žilje. Najpogostejša je ileokolična invaginacija. Diagnozo lahko postavimo z irigografijo ali ultrazvokom. Ultrazvočni znaki so t.i. kokarda v kokardi, zadebeljena stena z ali brez znakov prekrvavitve ter prestenotična dilatacija z ojačano peristaltiko. Dezinvaginacijo lahko izpeljemo s kontrastnim sredstvom ali z zrakom pod rentgensko kontrolo ali s fiziološko raztopino pod ultrazvočno kontrolo. Bolniki in metode. Pri treh deklicah v starosti 15, 16 in 18 mesecev smo ob tipični klinični sliki ultrazvočno diagnosticirali ileokolično invaginacijo in nadaljevali z dezinvaginacijo pod ultrazvočno kontrolo. S pomočjo sistema za uvajanje barija pri irigografiji smo v široko črevo dovajali fiziološko raztopino, ogreto na telesno temperaturo. Posoda s tekočino je bila 1 m nad preiskovalno mizo. Količina uporabljene tekočine je bila več litrov, ker je zaradi nepopolne okluzije rektuma precej tekočine odteklo. Ultrazvočno smo opazovali potovanje vrha invaginata nazaj v proksimalni smeri. Poseg smo zaključili, ko je izginila tipična slika kokardev kokardi in je prišlo do refluksa tekočine v terminalni ileum. Rezultati. Poseg je bil uspešen in je potekal brez komplikacij pri vseh treh deklicah. Bolečine so takoj po posegu prenehale. Ob kontrolnih pregledih po 2 in 12 urah ni bilo več znakov invaginacije. Nekoliko edematozna je bila stena valvule Bauchini in terminalnega ileuma. Klinično stanje deklic je bilo normalno, tako da so bile odpuščene v domačo oskrbo neposredno po drugi ultrazvočni kontroli. Zaključki. Dezinvaginacija s hidrokolonsonografijo je zaradi visoke učinkovitosti in odsotnosti ionizirajočega sevanja metoda izbora. Zapleti doslej niso opisovani.


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