Clinical relevant factors of air enema reduction in children with intussusception
10.3760/cma.j.issn.1673-4904.2018.07.011
- VernacularTitle:影响儿童肠套叠空气灌肠复位的临床因素分析
- Author:
Lidan WANG
1
;
Sui HUANG
;
Yu CHEN
Author Information
1. 430016,华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)影像中心
- Keywords:
Intussusception;
Child;
Enema;
Retrospective studies
- From:
Chinese Journal of Postgraduates of Medicine
2018;41(7):623-626
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the clinical relevant factors of air enema reduction in children with intussusception. Methods The clinical data of 1 223 children with intussusception from January to October 2017 were reviewed retrospectively. The clinical features of air enema reduction failure were analyzed. Results Among the 1 223 children with intussusception, 1 140 children achieved successful reduction by air enema, and 83 children were failed. The reduction rate was 93.2% (1 140/1 223). Among the 83 failed children, 64 cases had bloody stools, 5 cases had no defecation since onset, and 51 cases were depression and lethargy. The course of disease was 6 h to 5 d. The ileocolonic intussusceptions was in 51 cases, ileo-ileo-colon intussusceptions in 15 cases, ileum-ileum intussusceptions in 6 cases, ileo-ileo-colonic-colonic intussusceptions in 3 cases, and ileum-cecum intussusceptions in 8 cases. Among the 51 ileocolonic intussusceptions children, there were 2 cases whose nested head located in the sigmoid, 6 cases in the liver area, 23 cases in the middle of the transverse colon, 15 cases in the middle of the ascending colon, and 5 cases in the ileocecal junction. The length of the intussusceptions was more than 5 cm, with 5 to 10 cm in 51 cases, 11 to 20 cm in 27 cases, and 21 to 30 cm in 5 cases. The diameter of nested head was 4 to 8 cm, with an average of 5 cm. The failed air enema children were treated with operation. Two cases of intestinal duplication, 13 cases of Meckel diverticulum, 2 cases of juvenile polyp, 2 cases of Peutz-Jeghers syndrome were found during operation. Conclusions There has low successful rate of air enema reduction in the children with long duration, much older, poor whole body condition and complex or secondary intussusception. Correct judgment of surgical indications could increase the successful rate of air enema reduction.
