నైరూప్య

Intussusception characteristics and ultrasound guided pneumatic reduction:A clinical experience in children less than 24 months old in Vietnam.

Linh Van Pham, Duc Minh Pham, Quynh Vu Ta, Dat Tan Nguyen, Phuong Minh Nguyen*

Background: Intussusception is a common pediatric emergency, the leading cause of mechanical bowel obstruction in infants.

Objectives: We aimed to examine the clinical, ultrasound characteristics and to evaluate the treatment outcomes of pneumatic reduction of intussusception in children younger than 24 months old in Vietnam.

Materials and Methods: An intervention study design without a control group was conducted. 182 children younger than 24 months diagnosed with intussusception were treated with the pneumatic reduction at Can Tho Children’s Hospital between January 1, 2017 and April 30, 2018. All patients were observed and recorded by the research members from initial hospitalization until discharge. Details of gender, age, intussusception history, the symptoms at hospitalization, clinical and ultrasound characteristics, and treatment results were obtained through structured questionnaires and medical records.

Results: Of the 182 patients, there were 105 males and 77 females with the age mean of 15.5 (SD 5.5) months. The main symptoms were abdominal pain (100%), vomiting (87.9%), a rectal examination with blood (23.6%), and touching the intestinal cage while a process of examining the belly (71.4%). 96.7% of cases were detected through an abdominal ultrasound. 96.6% of intestinal cage cases were found under the right rib and in which there were 69.9% of the image of steles and 4.6% of containing fluid on ultrasound. The success rate was 98.4%. After treating with the pneumatic reduction, there were 18.1% and 9.3% of relapse during hospitalization and after discharge respectively. All the relapse patients were successfully the second time treated with the pneumatic reduction. No side effects were found during the treatment.

Conclusions: Intussusception in children younger than 24 months old may be based on clinical or ultrasound signs to detect. Treating with the pneumatic reduction in these children has a high rate of success without side effects.