Blog

14 April, 2021 by Admin

Hydrostatic Reduction Of Ileo- Colic Intussusception

Hydrostatic Reduction Of Ileo- Colic Intussusception

Intussusception is one of the most common causes of acute abdomen in infancy. This condition is usually idiopathic in children between 6 months and 2 years of age with an incidence of 1-2 cases per thousand children. The vast majority of childhood cases of intussusception are ileocolic; that is, the ileum becomes telescoped into the colon. The diagnosis should be suspected in a child presenting with intermittent colicky abdominal pain with drawing up of legs, poor feeding, vomiting and per rectal passage of blood mixed with mucus (red currant jelly). The importance of early diagnosis lies in the fact that the condition can be managed by non operative treatment (Ultrasound Guided Hydrostatic Reduction) with success rate of more than 90%. Ultrasound is a highly sensitive modality for the diagnosis of intussusception with an almost 100% accuracy with a classical sign of target or doughnut.

Ultrasound-guided hydrostatic reduction (HSR) is currently the standard management of intussusception, with a success rate of more than 90%. Peritonitis and advanced intestinal obstruction are considered as contraindications for hydrostatic reduction.

The advantages of US guided HSR are -:

  • avoids radiation exposure
  • provides more information than fluoroscopic techniques
  • the reduction process can be monitored, visualizes all the components of the intussusception including post reduction edematous ileocaecal valve and
  • can more easily recognize pathological lead points.

The technique – : The procedure is done under mild sedation in the minor OT in the emergency department itself. A well-lubricated, 18–20 French Foley’s catheter is introduced 6–9 cm into the rectum, its balloon is inflated to keep it retained. The catheter is then connected to the intravenous fluid column about 100–150 cm from the level of the pubis of the patient. HSR isthen carried out under USG guidance, with normal saline flowing freely into the rectum without application of any external force to the saline bag. The sonologist monitors the reduction of intussusception on ultrasound. Two to three attempts, 4–6 h apart can be made prior tolabelingit irreducibleand subjecting the patient to surgery. Each sitting of saline reduction is carried out for a maximum of 20–25 min after which the procedure is abandoned.Repeat attempts are undertaken only in clinically stable patients where the initial attempt achieves at least partial reduction. Failure to reduce is an indication of Laparoscopic/open reduction. The risks of failure is more in cases of age group <1 year, delayed presentation (> 48 hours) and in the presence of pathological lead point.

After successful reduction, the patient is admitted in the ward for observation. The recurrence rate of intussusception after successful hydrostatic reduction is 10-15%. In such a scenario the management is repeat hydrostatic reduction unless the cause of intussusception is a pathological lead point.

Category : Hydrostatic Reduction

Tags: Hydrostatic Reduction, intussusception

Tag Cloud

Abdominal Cyst Adrenal Masses antenatal hydronephrosis Antenatal Hydronephrosis Diagnosed Appendicitis Best hypospadias surgeon in delhi best pediatric doctor best pediatric laparoscopy surgeon in Delhi best pediatric surgeon in Delhi best pediatric surgeon in India best pediatric urologist best pediatric urologist in Delhi Best pediatric urologist in India Bilateral Adrenal Pheochromocytoma Biliary atresia Bladder exstrophy Care after Hypospadias surgery Causes of Hydronephrosis causes of vesicoureteric reflux Choledochal cyst Colonic interposition Conjoined Twins Conjoined Twins Surgery Diagnosis Of Ureterocele Duplex Renal System Epispadias Esophageal Replacement Surgery In Children Failed Hypospadias Surgery Gallstones Gastric interposition Gastric tube interposition Genito-urinary disorders Hemi-Nephrectomy Hirschsprung disease Hydrocoele hydronephrosis Hydronephrosis Surgery Hydronephrosis surgery cost hydronephrosis treatment in Delhi Hydrostatic Reduction Hydrouretronephrosis Hypospadias hypospadias repair hypospadias surgeon in delhi Hypospadias Surgery Imperforate anus Inguinal Hernia intussusception Jejunal interposition kidney cancer in children Kidney salvage surgery kidney tumour in children Laparoscopic Laparoscopic Cholecystectomy Laparoscopic Splenectomy Laparoscopic Surgery Laparoscopic Surgery In Children laparoscopic urological surgeries in children Laproscopic Appendicectomy Management Of Undescended Testis Mediastinal tumors Merkel’s diverticulum Minimal Access Management Minimal access surgery minimally invasive surgery Neonatal Surgery in Delhi Nephroblastoma Paediatric Laparoscopic Surgeon In Delhi Paediatric Surgery Paediatric Urology pediatric disorders pediatric laparoscopic surgeon in Delhi Pediatric laparoscopic surgery in Delhi Pediatric laparoscopic surgery in India pediatric laparoscopy surgery Pediatric Robotic Surgery Pediatric surgeon pediatric surgeon in delhi pediatric surgeon in india Pediatric Surgery Pediatric Urodynamic services Pediatric urodynamics pediatric urological pediatric urologist Pediatric Urologist In Delhi Pediatric Urology pediatric urology surgeon Pelvi-ureteric Junction Pelvic-ureteric junction obstruction Pheochromocytomas Polycystic Kidney Posterior Urethral Valve Postnatal Management Of Hydronephrosis Prognosis Of Antenatal Hydronephrosis RAS surgeries Robotic Pyeloplasty Robotic Surgery Robotic Surgery In Children Scrotal Swelling Scrotal Swelling Treatment In India Signs of Hydronephrosis Symptoms Of Ureterocele Symptoms of vesicoureteric reflux Thoracoscopic Surgery Thoracoscopic Surgery In Children treatment for Wilms' tumour Treatment Of Duplex Renal System Treatment Options For Antenatal Hydronephrosis Undescended Testes In Children Undescended testicles Undescended Testicles In Children Undescended Testis Ureteral reimplantation Ureterocele Treatment In India ureteropelvic junction Ureteropelvic junction obstruction Ureteroureterostomy Urethral obstruction Urinary tract infection Urological surgeries in children Varicocele vesico ureteric reflux Vesicoureteral Reflux Vesicoureteral Reflux Causes Vesicoureteral Reflux Symptoms Vesicoureteral Reflux Treatment Vesicoureteral Reflux Treatment In India Voiding Cystourethrogram Wilms Tumor Wilms Tumor Treatment In Delhi Wilms Tumor Treatment In India Wilms’ tumour World birth defects day

Locations & Directions

BLK-Max Super Speciality Hospital
Building No-5, Pusa Road, Rajinder Nagar, New Delhi, India – 110005

+91 9582 413 828, 8766 350 320 | docpedsurg@gmail.com