OUTCOME OF ULTRASOUND GUIDED REDUCTION OF INTUSSUSCEPTION USING NORMAL SALINE: EXPERIENCE OF A TERTIARY CARE HOSPITAL OF PESHAWAR, PAKISTAN
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Abstract
OBJECTIVE: To determine the success rate of ultrasound guided hydrostatic reduction of intussusception using normal saline as an alternative to laparotomy.
METHODS: This prospective cross-sectional study was conducted at Pediatric Surgery department, Khyber Teaching Hospital, Peshawar from January-September 2018. Eighty patients aged between 3-24 months with clinical signs, symptoms and confirmatory sonographic evidence of intussusception were included in study. Procedure was carried out under ultrasound guidance using normal saline as medium for reduction. Maximum, three attempts were made each lasting 5-10 minutes.
RESULTS: Mean age of patients was 11.9±4.8 months. Majority (n=60/80; 75%) of patients were males. Thirty-five percent of patients (n=28/80) presented on second day followed by 32.5% (n=26/80) on first day. Mean time for presentation was 2.1±0.9 days. Most common type of intussusception was Ileo-colic (n=72/80; 90%). Overall success rate was 82.5% (n=66/88).
Success rate for patients presented within first day was 96.2% (n=25/26) as compared to 85.7% (n=24/28) in patients presented ≥1-2 days and 65.3% (17/26) in patients presented after two days. Reduction time of Intussusception ranged from 5-30 minutes with mean time of 17.5±1.4 minutes. In 76.3% (n=61/80) cases, intussusception was reduced within 20 minutes. In 14 (17.5%) patients, reduction could not be achieved (gangrenous gut=5, Meckel’s diverticulum=3, illeo-illeal intussusception=1, perforation=5). Recurrence rate of intussusception was 7.5% (n=6/80), including 4 (5%) cases within 24 hours and 2 (2.5%) cases within 2 months after reduction.
CONCLUSION: Ultrasound guided hydrostatic reduction of intussusception is an effective way to reduce intussusception, especially in patients presenting within two days.
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