Retrospective Comparison Study of Non-operative Treatment between Saline Hydrostatic Reduction under Ultrasonographic Guidance and Pneumatic Reduction under Fluoroscopic Guidance in Intussusception Patients at Queen Sirikit National Institute of Child He

Abstract

Background: Intussusception is a common cause of bowel obstruction in emergency setting of pediatric age. Prompt diagnosis and treatment are necessary. This condition is treatable by non-operative radiological method. Objective: To compare the results of non-operative treatment between saline hydrostatic reduction under ultrasonographic guidance and pneumatic reduction under fluoroscopic guidance in intussusception patients at Queen Sirikit National Institute of Child Health (QSNICH). Method: A retrospective cohort study to compare the success rate of treatment between saline hydrostatic reduction under ultrasonographic guidance and pneumatic reduction under fluoroscopic guidance in intussusception patients at QSNICH were collected between October 2017 and February 2019. Results: Fifty-three non-operative reduction of intussusception from 49 patients (age ranging from 2 months to 4 years 1 month) were enrolled. Thirteen from nineteen intussusceptions (68.4%) were successfully reduced by saline hydrostatic reduction under ultrasonographic guidance without perforation or recurrence. Thirty from thirty four intussusceptions (88.2%) were successfully reduced by pneumatic reduction under fluoroscopic guidance. Two patients had bowel perforation under the pneumatic reduction (perforation rate 5.9%). Five patients who treated by pneumatic method had the second episode of recurrence after the first intussusception at an interval of 2 days to 4 months (recurrent rate 14.7%). One patient underwent both hydrostatic method and pneumatic method consecutively with a failure from both methods. Conclusions: The success rate of hydrostatic method was not significant statistically difference from pneumatic method (p = 0.077).