HYDROSTATIC REDUCTION OF INTUSSUSCEPTION UNDER US GUIDANCE

The current nonoperative management of ileocolic intussusception inclu des hydrostatic and pneumatic reduction, both performed under fluorosc opic monitoring. Recently, a new technique - ultrasound-guided reducti on - replaced the conventional approach in our institution. Over a 20- month period, 46 intussusceptions were diagnosed sonographically in 40 patients. In all cases, reduction was attempted under ultrasound guid ance by means of a normal saline enema. In 42 cases (91%) reduction wa s successful and only four patients had to be operated (two resections , two manual reductions). Complications did not occur. This technique permits distinct visualization of the entire process, providing a clea r and detailed echogram of the fluid-filled large and small intestine. We established the following definite criteria of reduction: disappea rance of the target, demonstration of the ileocecal valve, visualizati on of the fluid reflux, and fluid filling of small bowel loops. The pr esented technique for the reduction of intussusception without radiati on exposure is reliable and safe, and appears to be one of the most pr omising methods for the nonoperative treatment of ileocolic intussusce ption.