Yadav Ajay Kumar, Yadav Neha, Dev Binit, Dahal Sonia, Yadav Rohit Prasad, Taparia Sushil, Patahak Hiramani
Department of Radiodiagnosis and Interventional Radiology, Birat Medical College & Teaching Hospital, Biratnagar, Morang, Nepal.
Department of Microbiology & Infectious Disease, Koshi Zonal Hopsital, Biratnagar, Morang, Nepal.
JNMA J Nepal Med Assoc. 2025 Feb;63(282):73-77. doi: 10.31729/jnma.8878. Epub 2025 Feb 28.
Intussusception is common cause of acute emergency responsible for bowel obstruction in infants and toddlers with peak age of incidence between 6-9 months. Ultrasound is imaging modality of choice for diagnosis of intussusception and ultrasound guided hydrostatic enema reduction is standard, nonsurgical, internationally preferred treatment modality for uncomplicated pediatric intussusceptions. This study was aimed to find the outcome of the procedure.
An observational cross-section was carried in a tertiary care center in children presenting with intussusception. Ultrasoud guided hydrostatic reduction was done in all radiologically confirmed intussusception in children presenting to our tertiary hospital from February 2023 to July 2024 fulfilling the inclusion criteria after proper resuscitation. Patients having marked abdominal distension with features of peritonitis were excluded from the study. Ethical approval was obtained from Institutional Review Committee (Reference number: 287/2023).
Total 81 patients with 84 intussusceptions underwent ultrasound guided hydrostatic reduction with male to female ratio of 2.86 and mean age 9.49±8.43 months. Hydrostatic reduction was successful in 78 (92.85%) cases. Among successful reductions, 3 (3.84%) patients had recurrence and repeat successful hydrostatic reduction was done. Presenting complain seen were abdominal pain 81 (100%) , vomiting 72 (88.89%). Ileocolic intussusception was seen in 74 (88.09%).
The success rate of ultrasound-guided hydrostatic reduction using normal saline for uncomplicated intussusception was consistent with findings from previous studies conducted in similar settings, which utilized both hydrostatic and pneumatic reduction methods.
肠套叠是婴幼儿急性肠梗阻的常见病因，发病高峰年龄在6至9个月之间。超声是诊断肠套叠的首选影像学检查方法，超声引导下的水压灌肠复位是治疗单纯性小儿肠套叠的标准、非手术且国际上首选的治疗方式。本研究旨在探讨该治疗方法的效果。
在一家三级医疗中心对患有肠套叠的儿童进行了一项观察性横断面研究。对2023年2月至2024年7月期间到我院就诊、经放射学确诊且符合纳入标准并经过适当复苏的所有肠套叠患儿进行超声引导下的水压复位。有明显腹胀且伴有腹膜炎体征的患者被排除在研究之外。获得了机构审查委员会的伦理批准（参考编号：287/2023）。
共有81例患者发生84次肠套叠，接受了超声引导下的水压复位，男女比例为2.86，平均年龄为9.49±8.43个月。水压复位成功78例（92.85%）。在成功复位的病例中，3例（3.84%）患者复发，再次成功进行了水压复位。出现的症状有腹痛81例（100%）、呕吐72例（88.89%）。回结肠套叠74例（88.09%）。
使用生理盐水进行超声引导下的水压复位治疗单纯性肠套叠的成功率与之前在类似环境中进行的研究结果一致，之前的研究同时使用了水压和气压复位方法。
