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PRESSURE-CONTROLLED ULTRASOUND-GUIDED SALINE REDUCTION OF INFANTILE INTUSSUSCEPTION

Rekha Agrawal, Vikesh Agrawal, Himanshu Acharya

Abstract


Introduction: Barium reduction poses to radiation hazard and chemical peritonitis and hence ultrasound guided saline reduction has advantages of safety, efficacy and direct observation during reduction. Saline reduction under ultrasound guidance has higher failure rate if adequate but safe pressure of flow is not used. We conducted a study in central India to assess the efficacy of pressure-controlled ultrasound-guided saline reduction(PUSR) in 32 infants.

Material and Methods: The study was carried out in Netaji Subhash Chandra Bose Medical College, Jabalpur in emergency between January 2015 and December 2017. Inclusion criteria were patient with triad of pain, lump and red currant jelly stools of less than one year age. Patients presenting after 48 hours, clinical evidence of peritonitis, toxemia, multiple air fluid levels on abdominal skiagram, ileo-ileal intussusception and absent vascularity in the mass on color Doppler were excluded. Under oral sedation with Triclophos pressure-controlled ultrasound-guided saline reduction was performed using sphygmomanometer cuff around saline bottle.

Results: A total 72 infants of intussusception were diagnosed in the mentioned period. 32 infants fulfilled the inclusion criteria and were taken for pressure-controlled ultrasound-guided saline reduction(PUSR). Out of 32 infants which were included in the study, 22(68.75%) had ileo-cecal intussusception, 5(15.62%) had ileo-sigmoid intussusception and 5(15.62%) had colo-colic intussusception. PUSR was successful in 30(93.75%) patients and failed in 2 cases. No patient showed recurrence within 24 hours. None of the patient developed perforation after the procedure.

Conclusion: Pressure-controlled ultrasound-guided saline reduction(PUSR) is a safe, effective and easy to learn technique for saline reduction in infants.

Corresponding Author: Dr. Rekha Agrawal.


Keywords


Intrussusception, PUSR, Pressure controlled ultrasound guided saline reduction, Saline reduction in infants, Infantile intrussusception, Radiation hazard.

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References


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