CHILDHOOD INTUSSUSCEPTION - ULTRASOUND-GUIDED HARTMANNS SOLUTION HYDROSTATIC REDUCTION OR BARIUM ENEMA REDUCTION

A comparison was made of the efficacy of ultrasound-guided Hartmann's solution hydrostatic reduction on 23 patients (US group) with the same number of consecutive patients in whom hydrostatic reduction was done by barium enema (BE group) under fluoroscopy for childhood intussusce ption. The US group was diagnosed by ultrasound scan and reduction was attempted under the guidance of ultrasonography with Hartmann's solut ion at 100 mm Hg pressure. Excluded were patients older than 12 years, patients in shock, patients with peritonitis, bowel perforation, and gross abdominal distension as well as recurrent intussusception of mor e than three episodes. There were three patients excluded in this grou p. The diagnosis of intussusception and complete reduction were confir med by gastrografin enema. This US group had three recurrences (3 of 2 6, 11.5%), one lead point (1 of 23, 4.4%), and 19 successful reduction s (19 of 26, 73%). Incidentally, there were also three patients exclud ed in this period of barium enema reduction. There was only one recurr ence (1 of 24, 4.2%), one leadpoint (1 of 23, 4.4%), and 12 successful reductions (12 of 24, 50%) in these 23 BE patients. The success rates for the ileo-colic intussusceptions with Hartmann's solution reductio n and barium enema reduction were 91% (19 of 21) and 55% (12 of 22), r espectively (P = .00865). There was no complication in either group, a nd the accuracy of diagnosing a complete reduction was 100% in both fo rms of reduction. Hence, ultrasound-guided hydrostatic reduction for c hildhood ileocolic intussusception is preferred because it is safe, ac curate, has a higher success rate, and can avoid radiation exposure ri sk. Copyright (C) 1997 by W.B. Saunders Company