Risk factors for failure of enema reduction of intussusception in children.
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
06 Sep 2024
06 Sep 2024
Historique:
received:
20
05
2024
accepted:
27
08
2024
medline:
7
9
2024
pubmed:
7
9
2024
entrez:
6
9
2024
Statut:
epublish
Résumé
Intussusception is a common surgical emergency in children. Clinical suspicion and radiological evaluation confirm the diagnosis of the disease. Enema reduction is the first line of management. This study aimed to explore the risk factors associated with enema reduction failure. A retrospective analysis of patients diagnosed with intussusception at three different hospitals in different countries from January 2016 to December 2022. Data collected included demographics, presenting symptoms, duration of symptoms, management, outcomes, and follow-ups. A total of 290 cases of intussusception were included in the study. Ages ranged from 1 to 36 months, with a median age of 15 months. All children underwent an enema reduction which was successful in 92.4%. Failure of reduction was seen in 16.7% of females compared to 6.4% of males, and it was significantly seen in children below the age of 1 year compared to older children. Failure of reduction significantly increases with the duration of symptoms and in children who present with bilious vomiting and currant jelly stool. In conclusion, Failure of enema reduction was more prevalent in females, in children below the age of 1 year and who present late, as well as children who had bilious vomiting and currant jelly stool. This study identified several risk factors associated with failed enema reduction in children with intussusception. Recognizing the risk factors can help guide clinicians in the management and anticipation of outcomes.
Identifiants
pubmed: 39242784
doi: 10.1038/s41598-024-71289-3
pii: 10.1038/s41598-024-71289-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
20786Informations de copyright
© 2024. The Author(s).
Références
Sorantin, E. & Lindbichler, Franz. Management of intussusception. Rofo 14, L146–L154. https://doi.org/10.1007/s00330-003-2033-2 (2004).
doi: 10.1007/s00330-003-2033-2
Khorana, J. et al. Enema reduction of intussusception: The success rate of hydrostatic and pneumatic reduction. Ther. Clin. Risk Manag. https://doi.org/10.2147/tcrm.s92169 (2015).
doi: 10.2147/tcrm.s92169
pubmed: 26719697
pmcid: 4687953
Beres, A. L. & Baird, R. An institutional analysis and systematic review with meta-analysis of pneumatic versus hydrostatic reduction for pediatric intussusception. Surgery 154, 328–334. https://doi.org/10.1016/j.surg.2013.04.036 (2013).
doi: 10.1016/j.surg.2013.04.036
pubmed: 23889959
Ripley, B. D. Modern Applied Statistics with S (Springer, 2002).
Wickham, H. & Wickham, H. Data Analysis (Springer, 2016).
Sun, Z., Song, G., Lian, D., Zhang, Q. & Dong, L. Process management of intussusception in children: A retrospective analysis in China. Pediatr. Emerg. Care 38, 321 (2022).
doi: 10.1097/PEC.0000000000002700
pubmed: 35766925
pmcid: 9245550
Litz, C. N. et al. Outpatient management of intussusception: A systematic review and meta-analysis. J. Pediatr. Surg. 54, 1316–1323 (2019).
doi: 10.1016/j.jpedsurg.2018.09.019
pubmed: 30503194
Hadidi, A. T. & El Shal, N. Childhood intussusception: A comparative study of nonsurgical management. J. Pediatr. Surg. 34, 304–307. https://doi.org/10.1016/s0022-346890196-3 (1999).
doi: 10.1016/s0022-346890196-3
pubmed: 10052810
Delgado-Miguel, C. et al. Intussusception management in children: A 15 year experience in a referral center. Indian J. Pediatr. 19, 1–6 (2022).
Deshmukh, S. N., Sanghvi, Z. N. & Pawar, R. R. Intussusception in children: A prospective cohort study. Int. J. Anatomy Radiol. Surg. (2022).
Kim, P. H. et al. Predictors of failed enema reduction in children with intussusception: A systematic review and meta-analysis. Eur. Radiol. 31, 8081–8097 (2021).
doi: 10.1007/s00330-021-07935-5
pubmed: 33974147
Xie, X. et al. A randomized trial of pneumatic reduction versus hydrostatic reduction for intussusception in pediatric patients. J. Pediatr. Surg. 53, 1464–1468 (2018).
doi: 10.1016/j.jpedsurg.2017.08.005
pubmed: 28827051
Carroll, A. G. et al. Comparative effectiveness of imaging modalities for the diagnosis and treatment of intussusception. AJR Am. J. Roentgenol. 24, 521–529. https://doi.org/10.1016/j.acra.2017.01.002 (2017).
doi: 10.1016/j.acra.2017.01.002
Ng, A. W. Y. et al. Childhood intussusception: 17 year experience at a tertiary referral centre in Hong Kong. HKMJ 21, 518–524 (2015).
Sadigh, G., Zou, K. H., Razavi, S. A., Khan, R. & Applegate, K. E. Meta-analysis of air versus liquid enema for intussusception reduction in children. AJR Am. J. Roentgenol. 205, W542–W549. https://doi.org/10.2214/ajr.14.14060 (2015).
doi: 10.2214/ajr.14.14060
pubmed: 26496576
Chukwu, I. S., Ekenze, S. O., Ezomike, U. O., Emeka, C. K. & Ekpemo, S. C. Ultrasound-guided reduction of intussusception in infants in a developing world: Saline hydrostatic or pneumatic technique?. Eur. J. Pediatr. 182, 1049–1056. https://doi.org/10.1007/s00431-022-04765-5 (2022).
doi: 10.1007/s00431-022-04765-5
pubmed: 36562833
Fakhry, T., Fawzy, A. N. & Mahdy, A. T. The efficacy of delayed, repeated reduction enema in management of intussusception. Ann. Pediatr. Surg. 17, 1–5 (2021).
doi: 10.1186/s43159-021-00072-0
Ma, G. M., Lillehei, C. & Callahan, M. J. Air contrast enema reduction of single and recurrent ileocolic intussusceptions in children: Patterns, management and outcomes. Pediatr. Radiol. 50, 664–672 (2020).
doi: 10.1007/s00247-020-04612-5
pubmed: 32006065
Binu, V. et al. Ultrasound guided hydrostatic enema reduction of ileocolic intussusception: a safe and effective technique. ANZ J. Surg. 93, 1993–1998 (2023).
doi: 10.1111/ans.18502
pubmed: 37158232
Radu, S., Lin, S., Le, L. D., Fialkowski, E. & Zigman, A. Delayed repeat contrast enema for treatment of pediatric intussusception. J. Surg. Res. 275, 109–114 (2022).
doi: 10.1016/j.jss.2022.01.008
pubmed: 35259668
Yu, F. et al. A technique to reduce the early recurrence of intussusception in ultrasound-guided hydrostatic reduction. J. Ultrasound Med. 41, 2467–2473 (2022).
doi: 10.1002/jum.15933
pubmed: 34952973
Ravitch, M. M. Diagnosis and treatment intussusception—a surgical condition. Pediatrics 38, 122–123 (1966).
doi: 10.1542/peds.38.1.122
pubmed: 5936874
Al-Tokhais, T. et al. Antibiotics administration before enema reduction of intussusception: Is it necessary?. J. Pediatr. Surg. 47, 928–930. https://doi.org/10.1016/j.jpedsurg.2012.01.050 (2012).
doi: 10.1016/j.jpedsurg.2012.01.050
pubmed: 22595575
Attoun, M. A. et al. The management of intussusception: A systematic review. Cureus 15, e49481. https://doi.org/10.7759/cureus.49481 (2023).
doi: 10.7759/cureus.49481
pubmed: 38152810
pmcid: 10752083
Binu, V. et al. Ultrasound guided hydrostatic enema reduction of ileocolic intussusception: A safe and effective technique. ANZ J. Surg. 93, 1993–1998. https://doi.org/10.1111/ans.18502 (1993).
doi: 10.1111/ans.18502
Chukwu, I. S., Ekenze, S. O., Ezomike, U. O., Chukwubuike, K. E. & Ekpemo, S. C. Ultrasound-guided reduction of intussusception in infants in a developing world: Saline hydrostatic or pneumatic technique?. Eur. J. Pediatr. 182, 1049–1056. https://doi.org/10.1007/s00431-022-04765-5 (2023).
doi: 10.1007/s00431-022-04765-5
pubmed: 36562833
Chukwubuike, K. E. & Nduagubam, O. C. Hydrostatic reduction of intussusception in children: A single centre experience. Pan. Afr. Med. J. 36, 263 (2020).
doi: 10.11604/pamj.2020.36.263.21380
pubmed: 33088392
pmcid: 7546016
Dobson, A. J. & Barnett, A. G. An Introduction to Generalized Linear Models (Chapman and Hall/CRC, 2018).
Lindbichler, F. & Sorantin, E. Management of intussusception. Eur. Radiol. Suppl. 14, L146–L154. https://doi.org/10.1007/s00330-003-2033-2 (2004).
doi: 10.1007/s00330-003-2033-2
Liu, L. et al. Air enema reduction versus hydrostatic enema reduction for intussusceptions in children: A systematic review and meta-analysis. PLoS ONE 19, e0297985. https://doi.org/10.1371/journal.pone.0297985 (2024).
doi: 10.1371/journal.pone.0297985
pubmed: 38498581
pmcid: 10947698
Öztaş, T. & Deveci, G. Is phosphate enema treatment effective in ileocolic intussusception?. HK J. Paediatr. (New Series). 28(1), 8–12 (2023).
Shen, G. et al. Risk factors for short-term recurrent intussusception and reduction failure after ultrasound-guided saline enema. Pediatr. Surg. Int. 34, 1225–1231. https://doi.org/10.1007/s00383-018-4340-3 (2018).
doi: 10.1007/s00383-018-4340-3
pubmed: 30151752
Taher, H. E. H., Abd El-Aziz, M., Mostafa, A. A. A. F. & Ali, Y. M. A. Comparative study between hydrostatic and pneumatic reduction for early intussusception in pediatrics. Al Azhar Int. Med. J. 3, 1–6. https://doi.org/10.21608/aimj.2022.113210.1756 (2022).
doi: 10.21608/aimj.2022.113210.1756