{"id":132,"date":"2021-04-19T04:59:08","date_gmt":"2021-04-19T04:59:08","guid":{"rendered":"http:\/\/www.paedsurgeryindelhi.com\/blog\/?p=132"},"modified":"2021-04-19T05:07:12","modified_gmt":"2021-04-19T05:07:12","slug":"intussusception","status":"publish","type":"post","link":"https:\/\/www.paedsurgeryindelhi.com\/blog\/intussusception\/","title":{"rendered":"Intussusception"},"content":{"rendered":"\n<p>Intussusception is one of the most common causes of acute abdomen  in infancy. This condition is usually idiopathic in children between 6 months  and 2 years of age with an incidence of 1-2 cases per thousand children. The  vast majority of childhood cases of intussusception are ileocolic; that is, the  ileum becomes telescoped into the colon. The diagnosis should be suspected in a child presenting with  intermittent colicky abdominal pain with drawing up of legs, poor feeding,  vomiting and per rectal passage of blood mixed with mucus (red currant jelly).  The importance of early diagnosis lies in the fact that the condition can be  managed by non-operative treatment (Ultrasound Guided Hydrostatic Reduction)  with success rate of more than 90%. Ultrasound is a highly sensitive  modality for the diagnosis of intussusception with an almost 100% accuracy  with a classical sign of target or doughnut.&nbsp;<\/p>\n<p>Ultrasound-guided hydrostatic reduction (HSR) is currently  the standard management of intussusception, with a success rate of more than  90%. Peritonitis  and advanced intestinal obstruction are considered as contraindications for  hydrostatic reduction. <\/p>\n  <p>The advantages of US guided HSR are -:<\/p>\n<ul class=\"list01\">\n  <li>avoids radiation exposure<\/li>\n   <li> provides  more information than fluoroscopic techniques<\/li>\n   <li> the reduction process can be  monitored, visualizes all the components of the intussusception including post  reduction edematous ileocaecal valve and<\/li>\n    <li> can more easily recognize  pathological lead points.<\/li>\n<\/ul>\n<p><strong>The  technique -:<\/strong> The procedure is done under mild sedation in the minor OT in the  emergency department itself. A well-lubricated,  18\u201320 French Foley&#8217;s catheter is introduced 6\u20139 cm into the rectum, its balloon  is inflated to keep it retained. The catheter is then connected to the  intravenous fluid column about 100\u2013150 cm from the level of the pubis of the  patient. HSR is then carried out under USG guidance, with normal saline flowing  freely into the rectum without application of any external force to the saline bag.  The sonologist monitors the reduction of intussusception on ultrasound. Two to  three attempts, 4\u20136 h apart can be made prior to labeling it irreducible and subjecting the patient to surgery. Each  sitting of saline reduction is carried out for a maximum of 20\u201325 min after  which the procedure is abandoned. Repeat attempts are undertaken only in clinically stable  patients where the initial attempt achieves at least partial reduction. Failure  to reduce is an indication of Laparoscopic\/open reduction. The risk of failure  is more in cases of age group &lt;1 year, delayed presentation (&gt; 48 hours)  and in the presence of pathological lead point.<\/p>\n<p>After  successful reduction, the patient is admitted in the ward for observation. The recurrence  rate of intussusception after successful hydrostatic reduction is 10-15%. In  such a scenario the management is repeat hydrostatic reduction unless the cause  of intussusception is a pathological lead point.<\/p>\n<p><img decoding=\"async\" src=\"https:\/\/www.paedsurgeryindelhi.com\/blog\/wp-content\/uploads\/2021\/04\/img2.jpg\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Intussusception is one of the most common causes of acute abdomen  in infancy. This condition is usually idiopathic in children between 6 months  and 2 years of age with an incidence of 1-2 cases per thousand children.<\/p>\n","protected":false},"author":1,"featured_media":134,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[52],"tags":[53],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.10 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Intussusception<\/title>\n<meta name=\"description\" content=\"Intussusception is one of the most common causes of acute abdomen in infancy.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.paedsurgeryindelhi.com\/blog\/intussusception\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Intussusception\" 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