Department of Medical Imaging, Hadassah - Hebrew University Medical Center, Jerusalem, Israel.
Br J Radiol. 2011 Aug;84(1004):719-26. doi: 10.1259/bjr/19392930. Epub 2010 Nov 16.
The prompt identification of children in whom enema reduction of intussusception might fail and surgery is necessary is crucial in order to avoid futile repeat attempts and untoward complications. The purpose of this retrospective review was to determine whether air encircling the intussusceptum in the small bowel during air enema for intussusception reduction could serve as an indication for operation rather than repeat attempts at radiological reduction.
Imaging studies of 83 children aged 4 to 40 months with idiopathic intussusception who had air enema for intussusception reduction were reviewed for the presence of air encircling the intussusceptum in the distal small bowel. Findings were correlated with clinical course and surgical findings.
In 12 of 83 patients, air was seen encircling the intussusceptum in the small bowel, and in 11 of these (88%) air enema failed to reduce the intussusception. In 8 of the 11, delayed repeated attempts using air enema failed to reduce intussusception. Clinical signs and their duration did not differ between those children without and those with air encircling the intussusceptum.
In the presence of air encircling the intussusceptum in the distal small bowel on air enema, delayed repeated attempts for intussusception reduction are unlikely to succeed, and surgery is indicated.
及时识别肠套叠患儿，避免反复无效尝试和不良并发症，对肠套叠患儿行灌肠复位治疗失败需行手术治疗至关重要。本回顾性研究旨在明确肠套叠空气灌肠复位过程中，小肠内套叠周围环绕气体是否可以作为行手术治疗而非重复影像学复位的指征。
回顾性分析 83 例 4 至 40 月龄肠套叠患儿的影像学资料，这些患儿均行空气灌肠复位治疗。分析空气灌肠复位过程中远端小肠内套叠周围是否环绕气体，并将影像学表现与临床过程和手术结果进行相关性分析。
83 例患儿中 12 例（14.5%）小肠内套叠周围环绕气体，其中 11 例（88%）患儿空气灌肠复位失败。11 例中 8 例（72%）延迟重复使用空气灌肠复位治疗仍未成功。未发现存在套叠周围环绕气体的患儿与不存在套叠周围环绕气体的患儿之间的临床症状及其持续时间存在差异。
肠套叠空气灌肠复位过程中，若存在小肠内套叠周围环绕气体，延迟重复复位治疗成功率低，应行手术治疗。
