ILEO-COLIC INTUSSUSCEPTION;

IS HYDROSTATIC REDUCTION WORTH CONSIDERING TILL LATE?

Abstract

Objective: To evaluate the success rate of hydrostatic reduction of intussusception
and incidence of complications in late presenting cases. Study Design: prospective study.
Place and duration of study: Study was carried out in Armed Forces Institute of Radiology
and Imaging Rawalpindi and different Combine Military Hospitals during last 5 years. Materials
and Methods: All the children up to 2 years age with diagnosis of ileo-colic intussusception
and 3 days or less history of onset of symptoms were included in the study. Patients with signs
of perforation, suspicion of lead point or long intussusceptum protruding through rectum were
excluded. After plain film evaluation, thin barium was instilled through Foleys catheter under
fluoroscopic guidance. Rule of 3 was followed and reduction was considered successful when
contrast refluxed into terminal ileal segment. Follow up plain x-ray and ultrasound was done
after 48 hours to rule out recurrence. Results: Hydrostatic reduction was successful in 18 out
of 21 patients collected during last five years. Reduction was incomplete in one case while
perforation was observed in 2 cases. These complications were observed in the largest group
(52%) of patients reporting on 3rd day of onset of symptoms. A significant number (38%) of
patients reached the hospital within 48 hours. Only 2 (10%) patients presented in first 24 hrs
but uneventful reduction was possible in later two groups. Conclusions: Careful hydrostatic
reduction in cases of ileo-colic intussusception reporting within 72 hrs will reduce hospital stay
and patient morbidity in most of the cases.