Vázquez ME, Anido EV, Vázquez MYE, Vázquez MYT

Language: Spanish
References: 24
Page: 265-272
PDF size: 127.57 Kb.

ABSTRACT

Introduction: idiopathic intestinal intussusceptions are the most frequent cause of acute abdomen in the breastfed baby and in the transitional infant. The medical treatment is the choice provided that the inclusion criteria are met since it is less invasive, costly and complicated but more effective than the surgical treatment.
Objective: to evaluate the effectiveness of the medical treatment in children with intestinal intussusception.
Methods: retrospective, longitudinal and descriptive study conducted in 55 patients who had been diagnosed with idiopathic intestinal intussusceptions and met the medical treatment criteria met; they had been admitted to the pediatric surgical service of Centro Habana university pediatric hospital in the period of January 2000 through December 2012. The used methods were pneumocolon and barium enema colon. Chi-square test was used for the analysis.
Results: the barium enema treatment slightly prevailed over pneumocolon (28 vs. 27) for 50.9 % and 49.1 %, respectively. The pneumocolon effectiveness (77.8 %) was higher than the barium enema (57.1 %) (RR= 1.38, p › 0.05). The effectiveness of both procedures depends on the time of progression of disease, which means that best results go to less time of progression.
Conclusions: no significant variations were found in the results of the two suggested medical procedures, although pneumocolon was more effective than barium enema.

REFERENCES

1. Blanch AJ, Perel SB, Acworth JP. Paediatric intussusception: epidemiology and outcome. Emerg Med Australia. 2007;19:45-8.

2. Navarro O, Daneman A. Intussusception. Diagnosis and management of those with and identifiable or predisposing cause and those that reduce spontaneously. Pediatr Radiol. 2004;34:305-9.

3. Colombani PM, Scholz S. Intussusception. In: Coran AG. Pediatric Surgery. 7 ed. Philadelphia: Saunders; 2011. p. 1093-110.

4. Romeo C, Fallat ME. Intussusceptions. In: Ashcraft KW. Pediatric Surgery. 5 ed. Philadelphia: Saunders; 2010. p. 508-16.

5. Quian J, Mas M, Jurado R. Invaginación Intestinal. Estudio de su incidencia un año en Uruguay. Arch Pediatr Urug. 2005;76(2)110-7.

6. Fiorito ES, Recalde Cuesta MD. Insuflación controlada barorradioscopicamente, método de elección en el diagnóstico y tratamiento de la invaginación intestinal. Actas Jornadas Argentinas de Pediatría. 1995;24:241-9.

7. Saenz AM, Paviotti RO. Diagnóstico y tratamiento de la invaginación intestinal en la infancia por el método de insuflación controlada barorradioscopicamente. Arch Arg Pediatr. 1956:46:115.

8. Aplegate KE. Intussusceptions in children: Imaging choices. Semin Roentgenol. 2008;43:15-9.

9. Fischer TK, Bihrmann K, Perch M. Intussusceptions in early childhood: a cohort study of 1.7 million children. Pediatrics. 2004;114:782-5.

10. Ko SF, Tiao MM, Hsiett C. Pediatric small bowel intussusceptions disease; feasibility of screening for surgery with early computed tomographic evaluation. Surgery. 2010;147:521.

11. Ortega X, Moenne K, Contardo V, Escaffi A, Pérez C. Invaginación de intestino delgado: aspectos ultrasonográficos y clínicos en pacientes pediátricos. Rev Chil Radiol Santiago. 2009;15(2):22-31.

12. Koplewitz BZ, Simanosky N, Lendesurt PD, Udassin R, Abu-Dalu K. Air encircling the intussusception on air enema for intussusception reduction: an indication for Surgery. The Bristish Journal of Radiology. August 2011;30:42-9.

13. Fragoso AC, Campos M, Tavares C. Pneumatic reduction of childhood intussusceptions. Is prediction failure important? J Pediatr Surg. 2007;42:1504.

14. Crankson SJ, Al-Rabeeah AA, Fischer JD, Al-Jaan SA, Namshan MA. Effective dose a pneumatic reduction of pediatric intussusceptions. Saudi Med J. 2003;24(5):518-20.

15. Schmit P, Rohrschneider WK, Chrismann D. Intestinal intussusceptions survey about diagnostic and nonsurgical Therapeutic procedures. Pediatr Radiol. 1999;29(10):752-6.

16. Garcia Meir C, Villalon Ortega M, Ramirez JM, Ciguelo MT. Why is it preferable to use air in the radiologist reduction of intestinal intussusceptions? An Esp Pediatr. 1999;51(1):39-44.

17. Tellado MG, Liras J, Mendez R, Sumira J, Mate A. Reducción hidrostática guiada por ecografía para el tratamiento de la invaginación intestinal idiopática. Cir Pediatric. 2003;16:166-8.

18. Kim MC, Strouse PJ, Peh WC. Clinics in diagnostic imagine. Ileocolic intussusceptions. Singapure Med J. 2002;43(12):645-8.

19. Davis CF, McCabe AJ, Raine PA. The ins and outs of intussusception: History and management over the past fifty year. J Pediatr Surg. 2003;38:60-4.

20. Kia K, Mony V, Drongowski R. Laparoscopic versus open surgical approach for intussusceptions requiring operative intervention. J Pediatr Surg. 2005;40:281-4.

21. Boychuk RB, Franke AA. Intussusception. Am Journal of Emerg Medicine. 2011;29:353-5.

22. Jen HC, Shew SB. The impact of hospital type and experience on the operative utilization in pediatric intussusceptions. Nationwide Study. J Pediatr Surg. 2009;(44):241-6.

23. Georgeson KE. Laparoscopic management of ileocolic intussusceptions. In: Holcomb III GW. Atlas of pediatric laparoscopy and thoracoscopy. Philadelphia: Sounders Elservier; 2008. p. 71-3.

24. Sherkherdimian S, Lee SL. Management of pediatric intussusceptions in general hospital: diagnosis, treatment and differences based on age. World J Pediatric. 2011;7(1):70-3.