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Article: Sonographically guided hydrostatic reduction of childhood intussusception using Hartmann's solution
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TitleSonographically guided hydrostatic reduction of childhood intussusception using Hartmann's solution
 
AuthorsPeh, WCG1
Khong, PL1
Chan, KL1
Lam, C1
Cheng, W1
Lam, WWM1
Mya, GH1
Saing, H1
Leong, LLY1
Low, LCK1
 
Issue Date1996
 
PublisherAmerican Roentgen Ray Society. The Journal's web site is located at http://www.arrs.org/scriptcontent/ajr/index.cfm
 
CitationAmerican Journal Of Roentgenology, 1996, v. 167 n. 5, p. 1237-1241 [How to Cite?]
 
AbstractOBJECTIVE. Currently, the standard methods for therapeutic reduction of intussusception in children involve considerable ionizing radiation. This study tested the effectiveness of sonographically guided hydrostatic reduction of intussusception using Hartmann's solution, a fluid with near- physiologic composition. SUBJECTS AND METHODS. Between March 1, 1994, and January 31, 1996, all children clinically suspected of having intussusception were evaluated by sonography. Those with positive findings on sonography were entered into the study and underwent confirmatory sonographically guided meglumine diatrizoate enema. During continuous sonographic monitoring, we used Hartmann's solution for attempted reduction of intussusception. Criteria for successful reduction were disappearance of the intussusceptum and passage of fluid through the ileocecal valve. Another sonographically guided meglumine diatrizoate enema was used to confirm successful reduction. RESULTS. We detected 25 consecutive intussusceptions in 22 patients. The patients were 12 girls and 10 boys, with a mean age of 14 months (range, 1- 72 months). Sonograms revealed in all patients doughnut or pseudokidney signs or both. The sites of intussusception were the transverse colon (17 of 25), hepatic flexure (4 of 25), ascending colon (2 of 25), splenic flexure (1 of 25), and descending colon (1 of 25). Other findings were dilated fluid- filled small bowel (11 of 25) and free intraperitoneal fluid (9 of 25). The success rate of our sonographically guided attempts at hydrostatic reduction was 76% (19 of 25). Success was proven by meglumine diatrizoate enema in all 19 patients. The mean time of the reduction procedure was 18 min (range, 2- 45 min). No complications occurred. All six patients in whom hydrostatic reduction was unsuccessful underwent surgery. Five of these patients had ileoileocolic intussusceptions. On sonography, when surrounded by fluid, ileoileocolic intussusceptions had a typically complex, fronded appearance. The remaining patient in whom hydrostatic reduction was unsuccessful had ileocolic intussusception. Of six ileoileocolic intussusceptions, one was hydrostatically reduced and a second was converted into an ileoileal intussusception before requiring surgery. The other four intussusceptions were surgically treated. CONCLUSION. Our data suggest that sonographically guided hydrostatic reduction with Hartmann's solution can be used to treat ileocolic intussusception and to diagnose ileoileocolic intussusception.
 
ISSN0361-803X
2012 Impact Factor: 2.897
2012 SCImago Journal Rankings: 1.529
 
ISI Accession Number IDWOS:A1996VR32900035
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorPeh, WCG
 
dc.contributor.authorKhong, PL
 
dc.contributor.authorChan, KL
 
dc.contributor.authorLam, C
 
dc.contributor.authorCheng, W
 
dc.contributor.authorLam, WWM
 
dc.contributor.authorMya, GH
 
dc.contributor.authorSaing, H
 
dc.contributor.authorLeong, LLY
 
dc.contributor.authorLow, LCK
 
dc.date.accessioned2008-06-12T06:32:13Z
 
dc.date.available2008-06-12T06:32:13Z
 
dc.date.issued1996
 
dc.description.abstractOBJECTIVE. Currently, the standard methods for therapeutic reduction of intussusception in children involve considerable ionizing radiation. This study tested the effectiveness of sonographically guided hydrostatic reduction of intussusception using Hartmann's solution, a fluid with near- physiologic composition. SUBJECTS AND METHODS. Between March 1, 1994, and January 31, 1996, all children clinically suspected of having intussusception were evaluated by sonography. Those with positive findings on sonography were entered into the study and underwent confirmatory sonographically guided meglumine diatrizoate enema. During continuous sonographic monitoring, we used Hartmann's solution for attempted reduction of intussusception. Criteria for successful reduction were disappearance of the intussusceptum and passage of fluid through the ileocecal valve. Another sonographically guided meglumine diatrizoate enema was used to confirm successful reduction. RESULTS. We detected 25 consecutive intussusceptions in 22 patients. The patients were 12 girls and 10 boys, with a mean age of 14 months (range, 1- 72 months). Sonograms revealed in all patients doughnut or pseudokidney signs or both. The sites of intussusception were the transverse colon (17 of 25), hepatic flexure (4 of 25), ascending colon (2 of 25), splenic flexure (1 of 25), and descending colon (1 of 25). Other findings were dilated fluid- filled small bowel (11 of 25) and free intraperitoneal fluid (9 of 25). The success rate of our sonographically guided attempts at hydrostatic reduction was 76% (19 of 25). Success was proven by meglumine diatrizoate enema in all 19 patients. The mean time of the reduction procedure was 18 min (range, 2- 45 min). No complications occurred. All six patients in whom hydrostatic reduction was unsuccessful underwent surgery. Five of these patients had ileoileocolic intussusceptions. On sonography, when surrounded by fluid, ileoileocolic intussusceptions had a typically complex, fronded appearance. The remaining patient in whom hydrostatic reduction was unsuccessful had ileocolic intussusception. Of six ileoileocolic intussusceptions, one was hydrostatically reduced and a second was converted into an ileoileal intussusception before requiring surgery. The other four intussusceptions were surgically treated. CONCLUSION. Our data suggest that sonographically guided hydrostatic reduction with Hartmann's solution can be used to treat ileocolic intussusception and to diagnose ileoileocolic intussusception.
 
dc.description.naturepublished_or_final_version
 
dc.format.extent418 bytes
 
dc.format.mimetypetext/html
 
dc.identifier.citationAmerican Journal Of Roentgenology, 1996, v. 167 n. 5, p. 1237-1241 [How to Cite?]
 
dc.identifier.epage1241
 
dc.identifier.hkuros21204
 
dc.identifier.isiWOS:A1996VR32900035
 
dc.identifier.issn0361-803X
2012 Impact Factor: 2.897
2012 SCImago Journal Rankings: 1.529
 
dc.identifier.issue5
 
dc.identifier.openurl
 
dc.identifier.pmid8911188
 
dc.identifier.scopuseid_2-s2.0-10344242383
 
dc.identifier.spage1237
 
dc.identifier.urihttp://hdl.handle.net/10722/49012
 
dc.identifier.volume167
 
dc.languageeng
 
dc.publisherAmerican Roentgen Ray Society. The Journal's web site is located at http://www.arrs.org/scriptcontent/ajr/index.cfm
 
dc.publisher.placeUnited States
 
dc.relation.ispartofAmerican Journal of Roentgenology
 
dc.relation.referencesReferences in Scopus
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.subject.meshColonic Diseases - surgery - therapy - ultrasonography
 
dc.subject.meshIntussusception - surgery - therapy - ultrasonography
 
dc.subject.meshIsotonic Solutions - administration & dosage - therapeutic use
 
dc.subject.meshUltrasonography, Interventional
 
dc.subject.meshBalloon Dilatation - instrumentation
 
dc.titleSonographically guided hydrostatic reduction of childhood intussusception using Hartmann's solution
 
dc.typeArticle
 
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<contributor.author>Cheng, W</contributor.author>
<contributor.author>Lam, WWM</contributor.author>
<contributor.author>Mya, GH</contributor.author>
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<description.abstract>OBJECTIVE. Currently, the standard methods for therapeutic reduction of intussusception in children involve considerable ionizing radiation. This study tested the effectiveness of sonographically guided hydrostatic reduction of intussusception using Hartmann&apos;s solution, a fluid with near- physiologic composition. SUBJECTS AND METHODS. Between March 1, 1994, and January 31, 1996, all children clinically suspected of having intussusception were evaluated by sonography. Those with positive findings on sonography were entered into the study and underwent confirmatory sonographically guided meglumine diatrizoate enema. During continuous sonographic monitoring, we used Hartmann&apos;s solution for attempted reduction of intussusception. Criteria for successful reduction were disappearance of the intussusceptum and passage of fluid through the ileocecal valve. Another sonographically guided meglumine diatrizoate enema was used to confirm successful reduction. RESULTS. We detected 25 consecutive intussusceptions in 22 patients. The patients were 12 girls and 10 boys, with a mean age of 14 months (range, 1- 72 months). Sonograms revealed in all patients doughnut or pseudokidney signs or both. The sites of intussusception were the transverse colon (17 of 25), hepatic flexure (4 of 25), ascending colon (2 of 25), splenic flexure (1 of 25), and descending colon (1 of 25). Other findings were dilated fluid- filled small bowel (11 of 25) and free intraperitoneal fluid (9 of 25). The success rate of our sonographically guided attempts at hydrostatic reduction was 76% (19 of 25). Success was proven by meglumine diatrizoate enema in all 19 patients. The mean time of the reduction procedure was 18 min (range, 2- 45 min). No complications occurred. All six patients in whom hydrostatic reduction was unsuccessful underwent surgery. Five of these patients had ileoileocolic intussusceptions. On sonography, when surrounded by fluid, ileoileocolic intussusceptions had a typically complex, fronded appearance. The remaining patient in whom hydrostatic reduction was unsuccessful had ileocolic intussusception. Of six ileoileocolic intussusceptions, one was hydrostatically reduced and a second was converted into an ileoileal intussusception before requiring surgery. The other four intussusceptions were surgically treated. CONCLUSION. Our data suggest that sonographically guided hydrostatic reduction with Hartmann&apos;s solution can be used to treat ileocolic intussusception and to diagnose ileoileocolic intussusception.</description.abstract>
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Author Affiliations
  1. The University of Hong Kong