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By Alejandro Peñarrieta Daher Residente de Cirugía Pediatrica en Hospital Infantil de México Federico Gómez
Jeremy G Fisher, Eric A Sparks, Christopher G B Turner, Justin D Klein, Elliot Pennington, Faraz A Khan, David Zurakowski, Emily T Durkin, Dario O Fauza, Biren P Modi
BACKGROUND: Air-contrast enema (ACE) is standard treatment for primary ileocolic intussusception. Management of recurrences is less clear. This study aimed to delineate appropriate therapy by quantifying the relationship between recurrence and need for bowel resection, pathologic lead points (PLP), and complication rates. METHODS: After IRB approval, a single institution review of patients with ileocolic intussusception from 1997 to 2013 was performed, noting recurrences, outcomes, and complications...
January 2015: Journal of Pediatric Surgery
Mehul V Raval, Peter C Minneci, Katherine J Deans, Kelli J Kurtovic, Ann Dietrich, D Gregory Bates, Shawn J Rangel, R Lawrence Moss, Brian D Kenney
OBJECTIVES: The purpose of this project was to implement a protocol facilitating discharge from the emergency department (ED) after successful radiologic ileocolic intussusception reduction in a pediatric referral center. METHODS: A multidisciplinary team identified drivers for successful quality improvement including educational brochures, a standardized radiologic report, an observation period in the ER with oral hydration challenges, and follow-up phone calls the day after discharge...
November 2015: Pediatrics
Zhe Wang, Qiu-ming He, Hong Zhang, Wei Zhong, Wei-qiang Xiao, Lian-wei Lu, Jia-kang Yu, Hui-min Xia
PURPOSE: To identify age risk factors of early recurrent intussusception after pneumatic enema reduction. Management opinions are proposed. METHODS: Two thousand two hundred and ninety-five intussusception patients' medical records from January 2009 to December 2011 were retrospectively reviewed and analyzed. RESULTS: Of the 2295 patients, the intussusception of 1917 of them was initially reduced by pneumatic enema, with 127 cases recurring within 72 h...
September 2015: Pediatric Surgery International
Cristina B Geltzeiler, Thomas L Sims, Andrew F Zigman
BACKGROUND/PURPOSE: Intussusception is the most common cause of bowel obstruction in children from 3 months to 3 years of age. In the absence of peritonitis, initial treatment is either hydrostatic or pneumatic reduction. If these measures fail, operative intervention is required. In nonreducible cases, we propose the use of intraoperative hydrostatic enema to achieve or confirm reduction. In this study we describe a cohort of patients who have undergone laparoscopic-assisted hydrostatic reduction of intussusception (LAHRI)...
September 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Timothy B Lautz, Cary W Thurm, David H Rothstein
BACKGROUND/PURPOSE: The purpose of the study is to compare outcomes between delayed repeat enema (DRE) and immediate surgery (IS) in children with ileocolic intussusception who fail initial enema reduction. METHODS: Retrospective cohort study of children <6 years-of-age from 2008 to 2012 in the Pediatric Health Information System (PHIS) database. Outcomes measured were bowel resection, length of stay (LOS), and adjusted hospital costs (AHC). RESULTS: 4980 of 6889 (72...
March 2015: Journal of Pediatric Surgery
Xian-Ming Yao, Zhong-Liang Chen, De-Lei Shen, Qi-Shuang Zhou, Song-Song Huang, Zu-Ren Cai, Yu-Long Tong, Meng Wang, Yi Ren, Xin-He Lai, Xiao-Ming Chen
PURPOSE: Intussusception is one of the most common causes of acute abdominal emergencies in infants and preschool children. Loss of intestine viability is the most serious complication of intussusception. This study aimed to investigate the risk factors for loss of intestine viability in pediatric intussusception cases among children. METHODS: Data were collected for operative pediatric intussusception cases (N = 316) from medical records of 5,537 hospitalized children due to intussusception between June 2009 and May 2014 in a pediatric surgery department of an academic teaching hospital in China...
February 2015: Pediatric Surgery International
Matthew P Gray, Shun-Hwa Li, Raymond G Hoffmann, Marc H Gorelick
BACKGROUND AND OBJECTIVE: Reported rates of recurrence after enema reduction for intussusception are variable. Concerns for recurrence influence postreduction management. The objective of this study was to conduct a systematic review and meta-analysis to estimate overall, 24-hour, and 48-hour recurrence rates after enema reduction in children. METHODS: PubMed, Cochrane Database, and OVID Medline were searched from 1946 through December 2011 using the search terms: intussusception, recurrence, and enema...
July 2014: Pediatrics
Nadja Apelt, Neil Featherstone, Stefano Giuliani
BACKGROUND: Idiopathic intussusception is one of the most common causes of small bowel obstruction in children. In the event of failed radiological reduction, laparotomy remains the treatment of choice. There is still no agreement in pediatric surgery about safety and effectiveness of the use of minimally invasive surgery in this common pediatric condition. By reviewing available data we aimed to establish whether laparoscopy should be the primary technique in the surgical reduction of intussusception...
August 2013: Journal of Pediatric Surgery
Alana L Beres, Robert Baird
BACKGROUND: Intussusception remains a frequent cause of bowel obstruction in children and typically is treated by reduction via enema. Controversy persists regarding the optimal reduction technique to maximize success while minimizing morbidity. METHODS: We reviewed our institutional data comparing outcomes of enema reduction that use contrast medium versus air. A systematic review also was undertaken of comparative studies evaluating pneumatic (oxygen or air) versus hydrostatic (any contrast medium) reduction...
August 2013: Surgery
Sarah J Hill, Curt S Koontz, Simone M Langness, Mark L Wulkan
BACKGROUND: Intussusception is a common cause of bowel obstruction in children, which sometimes necessitates operative reduction and or resection. We report our series of patients with intussusception who were treated laparoscopically (LAP group) compared with exploratory laparotomy (OPEN group). SUBJECTS AND METHODS: After institutional review board approval, a retrospective review was performed evaluating outcomes for patients requiring surgical reduction of intussusception over a 10-year period...
February 2013: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Yasuo Ito, Isao Kusakawa, Yuji Murata, Etsuji Ukiyama, Hirokazu Kawase, Shoichiro Kamagata, Shigeru Ueno, Toshio Osamura, Minoru Kubo, Masahiro Yoshida
BACKGROUND: The Japanese Society of Emergency Pediatrics has formulated evidence-based guidelines for the management of intussusception in children in order to diagnose intussusceptions promptly, to initiate appropriate treatment as early as possible, and to protect intussuscepted children from death. METHODS: Literature was collected systematically via the Internet using the key words "intussusception" and "children." The evidence level of each paper was rated in accordance with the levels of evidence of the Oxford Center for Evidence-based Medicine...
December 2012: Pediatrics International: Official Journal of the Japan Pediatric Society
Frankie B Fike, Vincent E Mortellaro, George W Holcomb, Shawn D St Peter
BACKGROUND: Initial management of intussusception is enema reduction. Data are scarce on predicting which patients are unlikely to have a successful reduction. Therefore, we reviewed our experience to identify factors predictive of enema failure. METHODS: A retrospective review of all episodes of intussusception over the past 10 years was conducted. Demographics, presentation variables, colonic extent of intussusceptions, and hospital course were collected. Extent of intussusception was classified as right, transverse, descending, and rectosigmoid...
May 2012: Journal of Pediatric Surgery
Arnaud Bonnard, Monique Demarche, Carla Dimitriu, Guillaume Podevin, Francois Varlet, Michel François, Ioannis Valioulis, Ivalis Valioulis, Hossein Allal
INTRODUCTION: Surgical management of intussusception is required for cases where enema reduction fails. Some articles report an advantage of the laparoscopic over the open approach, but complications such as serosal tearing and frank perforation have been described. We aim to determine the best indication of laparoscopy in the decisional management tree of intussusception. PATIENT AND METHOD: This is a retrospective chart review of all children with intussusception who failed hydrostatic enema reduction and who underwent immediate laparoscopic management...
July 2008: Journal of Pediatric Surgery
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