ULTRASOUND-GUIDED PNEUMATIC REDUCTION OF INTUSSUSCEPTION IN CHILDREN

Abstract

Introduction: Pediatric intussusception predominantly affects children aged 6 months to 3 years, with a higher incidence in males. Abdominal pain, red currant jelly stool, and an abdominal mass are present in only 25-50% of cases. Diagnosis is often facilitated by ultrasound. This study delves into the effectiveness of ultrasound-guided pneumatic reduction as a preferred non-operative method.
Methods: This was a prospective cross-sectional study, conducted at Nobel Medical College Teaching Hospital, Biratnagar, Nepal, from November 2019 to November 2022. All pediatric patients diagnosed with intussusception, and confirmed by ultrasonography were included. Exclusion criteria included extensive red currant stool, fever, obstruction, peritonitis, and hemodynamic instability. Success was clinically determined and confirmed by ultrasound. Variables analysed included age, gender, type, presenting complaint, symptom duration, intussusception length, and outcome. Ethical clearance was obtained from the Institutional Review Committee.
Results: A total of 98 children underwent ultrasound-guided pneumatic reduction over 3 years. The most common age group was 6 to 12 months, with 41 (41.84%) children, and male predominance with  56 (57.14%) male children. Ileocolic presentation was seen in 97 (98.98%), with severe abdominal pain being the most common presentation observed in 79 (80.6%) children. The symptoms usually presented early, with 43 (43.88%) children experiencing symptoms for <24 hours. Four cases experienced failure, and two experienced recurrences, with repeated pneumatic reductions alleviating the symptoms.
Conclusion: Pneumatic reduction is a cost-effective, safe, and successful treatment for pediatric intussusception. Swift intervention is crucial for optimal outcomes. Ultrasound-guided pneumatic reduction is recommended for its efficacy and safety.