Ahmad M M, Wani M D, Dar H M, Mir I N, Wani H A, Raja A N
Department of Surgery, Government Medical College Srinagar; Karan Nagar, Srinagar, Jammu and Kashmi, India.
S Afr J Surg. 2016 Mar;54(1):10-13.
Intussusception is an important and one of the most commonly encountered diagnoses of intestinal obstruction in the paediatric age group. Ultrasound-guided hydrostatic reduction is an effective, nonoperative treatment modality for this condition and is associated with a high success rate. In addition, it is simple and safe as the entire procedure is carried out with real-time ultrasound, without the hazard of radiation. The aim of this study was to evaluate the effi cacy and safety of ultrasound-guided hydrostatic reduction in the management of intussusceptions in the paediatric age group.
A case study was carried out on 89 patients diagnosed with intussusception using high-resolution ultrasonography over a period of two years, spanning February 2012 to January 2014. Ultrasound-guided hydrostatic reduction was performed in 78 of these patients, and 11 patients were excluded owing to clinical contraindications. Follow-up ultrasound was performed after 24 hours to rule out recurrence.
The disease was most prevalent in the age group 6-24 months. The ileocolic type was the most common. Mean duration (hours) was 17.02 ± 20.81 for time to presentation. Complete therapeutic reduction was achieved in 70 of the 78 cases, with a success rate of 90%. Two recurrences occurred in the following 24 hours, which were successfully reduced on the second attempt. Complications and mortality did not occur secondary to the procedure.
Our study found that ultrasound-guided hydrostatic reduction is a simple, safe and effective nonoperative treatment for intussusceptions in the paediatric age group, and should be the fi rst line of management in appropriate patients.
肠套叠是儿科年龄段肠梗阻的重要且最常见的诊断之一。超声引导下的水压灌肠复位术是治疗这种疾病的一种有效、非手术的治疗方式，成功率很高。此外，该方法简单且安全，因为整个操作过程是在实时超声引导下进行的，没有辐射危害。本研究的目的是评估超声引导下的水压灌肠复位术在治疗儿科肠套叠中的有效性和安全性。
对2012年2月至2014年1月两年间通过高分辨率超声诊断为肠套叠的89例患者进行了病例研究。其中78例患者接受了超声引导下的水压灌肠复位术，11例因临床禁忌症被排除。24小时后进行超声随访以排除复发。
该疾病在6 - 24个月龄组中最为常见。回结肠型最为常见。就诊时间的平均时长（小时）为17.02 ± 20.81。78例患者中有70例实现了完全治疗性复位，成功率为90%。在接下来的24小时内发生了2例复发，第二次尝试成功复位。该操作未引发并发症和死亡。
我们的研究发现，超声引导下的水压灌肠复位术是治疗儿科肠套叠的一种简单、安全且有效的非手术治疗方法，对于合适的患者应作为首选治疗方法。
