Hydrostatic Reduction Of Ileocolic Intussusception By Using Gastrografin Enema In Paediatric Patients

Original Article

Abstract

Objective: To assess the effectiveness of fluoroscopic guided gastrografin solution enema in reducing idiopathic ileocolic
intussusception.
Materials and Methods: From January 2014 to June 2015, DHQ Hospital Timergara conducted this prospective
observational research. Based on the clinical history and ultrasound confirmation, the diagnosis was made. All patients
diagnosed and brought in within 48 hours were included in the trial, while those who did not show up before 48 hours
were not. After passing a Foley’s catheter via the anus, the balloon was inflated. Gently injecting a diluted gastrografin
solution with normal saline under controlled pressure was done. Throughout the operation, many radiographs were
collected. When the contrast reached the small intestine, the process was stopped. Under fluoroscopy, we performed
hydrostatic reduction in every instance of gastrografin enema. Using the gastrografin enema, the intussusception was
effectively decreased in 10 out of 14 instances. The same oncologist who previously performed the reduction used ultrasonography to check its success.
Results: Our patients ranged in age from 4 to 12 years old. There were nine (75% of the total) men and five (25%)
women. Twelve out of fourteen patients (85%) who had gastrografin enema guided by fluoroscopy saw a complete
decrease. Eleven patients only needed one setting for a full reduction, and just one needed to have the surgery done twice.
Four individuals had the surgery stopped due to failure. In 1/12 cases, recurrence after effective reduction was seen.
There were no issues either during or after the surgery.
Conclusion: Hydrostatic reduction of intussusception with gastrografin enema under ultrasound or fluoroscopic
guidance is a very simple and safe nonoperative method for reducing intussusception in children.
Key Words: Intussusception, Hydrostatic reduction, fluoroscopic guidance, gastrografin enema.