Sedated ultrasound guided saline reduction (SUR) of ileocolic intussusception: 20 year experience
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In brief
In brief
Twenty-year retrospective study of 414 sedated ultrasound-guided saline reductions for pediatric ileocolic intussusception demonstrates 86% success rate with zero perforations. This radiation-free approach using propofol sedation achieved comparable outcomes to traditional fluoroscopic methods while eliminating ionizing radiation exposure and procedural discomfort.
Written by the GCMD Library team from the article.
Background
Ileocolic intussusception is a common abdominal emergency in children, diagnosed routinely with ultrasound and treated most frequently with fluoroscopic pneumatic reduction without sedation. Alternatively, ultrasound can also be used to obviate ionizing radiation and sedation can be used to avoid discomfort from the procedure. The purpose of this study was to present our experience with sedation using saline enema under ultrasound guided control to reduce ileocolic intussusception.
Materials and methods
This is a retrospective study of patients with ileocolic intussusception presenting to a tertiary care hospital between 1998 and 2018. We excluded the data of patients that underwent either fluoroscopic guided reduction with barium enema or primary surgery. All patients received sedation with propofol and subsequently underwent our sedated ultrasound guided saline reduction (SUR) protocol until reduction was confirmed.
Results
414 total reductions were performed in the 338 children who underwent our SUR protocol, of which 86.0% were successful. Zero perforations occurred during attempted reduction. 58 patients required surgery after a failed reduction (14.0%). There were 76 recurrent episodes that underwent our SUR protocol, of which 93.4% had a successful reduction.
Conclusion
The success rate of reduction was high and compared similarly to techniques that either use pneumatic reduction under radiation or refrain from administering a sedative prior to enema.
Level of evidence
Treatment study level III.