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Article: Sonographically guided hydrostatic reduction of childhood intussusception using Hartmann's solution

TitleSonographically guided hydrostatic reduction of childhood intussusception using Hartmann's solution
Authors
Issue Date1996
PublisherAmerican Roentgen Ray Society. The Journal's web site is located at http://www.arrs.org/scriptcontent/ajr/index.cfm
Citation
American 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.
Persistent Identifierhttp://hdl.handle.net/10722/49012
ISSN
2014 Impact Factor: 2.731
2014 SCImago Journal Rankings: 1.510
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorPeh, WCGen_HK
dc.contributor.authorKhong, PLen_HK
dc.contributor.authorChan, KLen_HK
dc.contributor.authorLam, Cen_HK
dc.contributor.authorCheng, Wen_HK
dc.contributor.authorLam, WWMen_HK
dc.contributor.authorMya, GHen_HK
dc.contributor.authorSaing, Hen_HK
dc.contributor.authorLeong, LLYen_HK
dc.contributor.authorLow, LCKen_HK
dc.date.accessioned2008-06-12T06:32:13Z-
dc.date.available2008-06-12T06:32:13Z-
dc.date.issued1996en_HK
dc.identifier.citationAmerican Journal Of Roentgenology, 1996, v. 167 n. 5, p. 1237-1241en_HK
dc.identifier.issn0361-803Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/49012-
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.en_HK
dc.format.extent418 bytes-
dc.format.mimetypetext/html-
dc.languageengen_HK
dc.publisherAmerican Roentgen Ray Society. The Journal's web site is located at http://www.arrs.org/scriptcontent/ajr/index.cfmen_HK
dc.relation.ispartofAmerican Journal of Roentgenologyen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshColonic Diseases - surgery - therapy - ultrasonographyen_HK
dc.subject.meshIntussusception - surgery - therapy - ultrasonographyen_HK
dc.subject.meshIsotonic Solutions - administration & dosage - therapeutic useen_HK
dc.subject.meshUltrasonography, Interventionalen_HK
dc.subject.meshBalloon Dilatation - instrumentationen_HK
dc.titleSonographically guided hydrostatic reduction of childhood intussusception using Hartmann's solutionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0361-803X&volume=167&issue=5&spage=1237&epage=1241&date=1996&atitle=Sonographically+guided+hydrostatic+reduction+of+childhood+intussusception+using+Hartmann%27s+solutionen_HK
dc.identifier.emailKhong, PL: plkhong@hkucc.hku.hken_HK
dc.identifier.emailLow, LCK: lcklow@hkucc.hku.hken_HK
dc.identifier.authorityKhong, PL=rp00467en_HK
dc.identifier.authorityLow, LCK=rp00337en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.pmid8911188en_HK
dc.identifier.scopuseid_2-s2.0-10344242383en_HK
dc.identifier.hkuros21204-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-10344242383&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume167en_HK
dc.identifier.issue5en_HK
dc.identifier.spage1237en_HK
dc.identifier.epage1241en_HK
dc.identifier.isiWOS:A1996VR32900035-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridPeh, WCG=7101824984en_HK
dc.identifier.scopusauthoridKhong, PL=7006693233en_HK
dc.identifier.scopusauthoridChan, KL=37004089600en_HK
dc.identifier.scopusauthoridLam, C=14119182300en_HK
dc.identifier.scopusauthoridCheng, W=7402169228en_HK
dc.identifier.scopusauthoridLam, WWM=35292558200en_HK
dc.identifier.scopusauthoridMya, GH=6602928992en_HK
dc.identifier.scopusauthoridSaing, H=7005715754en_HK
dc.identifier.scopusauthoridLeong, LLY=7004323766en_HK
dc.identifier.scopusauthoridLow, LCK=7007049461en_HK

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