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ORIGINAL ARTICLE
Year : 2022  |  Volume : 15  |  Issue : 5  |  Page : 739-745

Bedside hydrostatic saline enema reduction of pediatric intussusception: Our experience


Department of Paediatric Surgery, SMS Medical College, Jaipur, Rajasthan, India

Correspondence Address:
Dr. Rahul Gupta
Associate Professor, Department of Paediatric Surgery, SMS Medical College, Jaipur, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.mjdrdypu_867_21

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Context: The ultrasound-guided reduction by saline enema is a preferred nonsurgical procedure for intussusception. In a government setup where bedside ultrasound and round-the-clock trained radiologist facilities are unavailable, bedside saline enema reduction (without ultrasound guidance) may be an option. Aims: To evaluate the efficacy of bedside hydrostatic saline enema reduction in the treatment of pediatric intussusception; the secondary aim was to identify the patient subset in which it is more useful. Settings and Design: A retrospective study was conducted from January 2019 to May 2021 in all children with ultrasound-confirmed intussusception at our center. Subjects and Methods: All children were considered for non-operative bedside reduction with saline enema, excluding those with signs of peritonitis and shock. We allowed a maximum of three attempts of saline enema reduction. Results: There were 375 patients admitted with the diagnosis of intussusception in our institute. Out of these, 42 patients were subjected to bedside hydrostatic saline enema reduction. The patients in this group were in the age range of 5 months to 14 years. The success rate of bedside hydrostatic saline enema reduction was 90.47% (38 out of 42 cases). No perforations occurred during the procedure. The duration of symptoms and age of the patients did not influence the successful reduction in our series (p > 0.05). The duration of admission attained a statistically significant difference (p < 0.05) between those who had a successful non-operative reduction and those who subsequently had an operative intervention, that is, reduction or resection. There was no mortality. Conclusion: Bedside hydrostatic normal saline enema reduction of intussusception is a suitable non-operative technique of managing childhood intussusception in the carefully selected subset of patients. The technique is simple, safe, and cost-effective in a resource-limited setup.


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