Measurement and analysis of dose exposure in childhood intussusception reduction / 中国辐射卫生

Objective To investigate the dose of radiation in children under going X-ray-guided air enema reduction, and to provide a basis for reducing the risk of radiation injury in pediatric patients. Methods Data were collected from children with intussusception who were treated with air enema. The experimental conditions of high, medium, and low doses of three age groups were analyzed. Phantoms were used to simulate the operation, and the radiation dose was measured using a thermoluminescence system. Results In children with intussusception, the success rate of air enema under the guidance of X-ray was 88% (including secondary intussusception), with anearly re-intussusception rate of 8%. The effective dose of treatment ranged from 0.57 to 12.33 mSv, and the tissues and organs with high absorbed dose were mainly in the chest and abdomen. Conclusion Children in different groups are exposed to significantly differentand relatively high doses. The operators are recommended to use ultrasonic guidance. With X-ray guidance, the exposure time should be minimized and protective equipment for children should be used.

Application of anisodamine in modified air repair of intussusception in children / 实用放射学杂志

Objective To investigate the effect of anisodamine on air repair of intussusception in children,to improve the success rate of air enema reduction in children with acute intussusception.Methods Based on the clinical symptoms and ultrasound diagnosis,582 children who were diagnosed with intussusception and needed air enema reduction were divided into two groups according to the modified method of operation.Children in the control group were not injected 654-2 before the air enema;the experimental group received intramuscular injection of 654-2 before air enema.The success rate and total success rate of the first reduction were observed and compared between the two groups.Results In the control group,229 cases was successfully repaired,and the success rate was 83.9%;17 cases were successfully reset by two times after intramuscular injection of 654-2;the overall success rate was 90.1%.In the experimental group, 295 cases were successfully repaired for the first time,and the success rate was 95.5%;3 cases were successfully reset by two times;the overall success rate was 96.4%.The successful rate and the total success rate of the experimental group were higher than those of the control group.χ2=22.71,P<0.001,was statistically significant.Conclusion Air enema before intramuscular injection of 654-2 is helpful to improve the success rate of air enema reduction in children with acute intussusception.

Comparision of different fixation methods on lower limbs for the treatment of pediatric intussusception with air enema / 实用放射学杂志

Objective To investigate the value of lower limbs fixation methods for the treatment of intussusception in children with air enema with.Methods 2 1 1 pediatric patients with intussusception who had accepted the treatment of air enema with two dif-ferent fixation methods on lower limbs were enrolled.Comparisons of median treatment duration and therapeutic effect between the two methods were investigated.Results In 32 patients with knee-joint fixation method,27 were successful with median treatment duration 4.84 minutes.Meanwhile in other 179 ones with lower limbs fixation method,152 were successful with median duration 7.96 minutes.And the duration difference between two methods was found (P<0.05).Conclusion Knee-joint fixation may help significantly shorten the median treatment duration for the treatment of intussusception with air enema in children.

The analysis of instruction value of the color Doppler ultrasonography for the diagnosis and treatment of the pediatric intussusceptions / 重庆医学

Objective To explore the instruction value of the color Doppler ultrasonography for the diagnosis and treatment of the pediatric intussusceptions .Methods Retrospective study the color Doppler ultrasonographic performance of 114 patients with diagnosis of pediatric intussusception in the affiliated hospital of Zunyi medical college ,from October 2009 to June 2012 ,reviewed the case ,groups were compared according to the ways of therapeutic methods .Results All the 114 cases of children of the intus-susception are subject to air enema reset or surgery cured confirmed .Age younger than 12 months intussusception children ,air ene-ma reset were more likely to success ;the diameter of concentric circles levy,the length of sleeve for and the thickness of bowel wall were smaller ,the more suitable for outsiders air enema reset .The blood supply of scabbard of bowel wall and the mesenteric was rich ,the air enema reset had a higher success rate ,blood supply was poor and the success rate was lower .The success rate of air enema reset was influenced by the part of intussusception .Conclusion Combined use of conventional color ultrasonic and high fre-quency probe checking ,can raise the diagnosis rate of pediatric intussusception ,the primary lesion confirmed and the detection rate in the position of the disease ,provide guidance for clinical choice reduction treatment .

Colon Perforation during Air Enema Reduction of Intussusception

PURPOSE: Although air enema reduction has been known as a good method of diagnosis and treatment of intussusception, it could develop colon perforation. However, there have been few studies about this complication. So we analyzed the risk factors of colon perforation during air enema reduction in patients with intussusception. METHODS: We reviewed the charts of 12 colon perforation patients during air enema reduction of intussusception, who were admitted to Gil Medical Center from Jan. 1990 to Dec. 2001. Their age, sex, major symptoms, length of time till hospital visit, types of intussusception, operative findings and pathologic reports were reviewed. RESULTS: Among 657 cases, 596 patients(90.7%) were successfully treated, but 12 patients(1.83%) failed in air enema reduction and had colon perforation. In patients with colon perforation the male to female ratio was 11 : 1, and average age was 5.3 months. The most common symptom at the time of hospital visit was vomiting(91.7%). Cyclic irritability(75.0%), bloody stool(75.0%) and abdominal mass(41.7%) were also noted. The average length of time between symptom onset and hospital visit was 44.7 hours. Types of intussusception were predominantly ileocolic, ileocecal, and ileoileocolic. The site of perforation was most commonly found at the proximal part of intussusception including ascending colon(50%) and transverse colon(50%). Most cases were uncomplicated, and had a single perforation. Pathologic reports showed hemorrhagic necrosis and mesenteric laceration at the site of colon perforation. Complications of colon perforation were tension pneumoperitonium(58.3%), requiring immediate decompression. CONCLUSION: The chance of colon perforation during air enema reduction increases in cases with small bowel obstruction on simple abdominal x-ray of a patient younger than 6 months, delay in time till hospital visit and higher air pressure during reduction. Therefore more careful investigation is needed in these cases.

Clinical evaluation of anisodamine in the air reduction for child intussusception / 介入放射学杂志

Objective To evaluate the effect of anisodamine in the air reduction for child intussusception. Methods Repeating the air reduction method for child intussusception after 20-30 min, muscular injection of anisodamine 5 mg, in 550 failure patients with routine air reduction method. Results 468 cases of intussusception persisted after routine air reduction were undergone second air reduction after administation of anisodamine with all outcoming of successful reduction. Other 82 cases still remained with intussusception after repeating the same procedure with anisodamine injection including 2 perforation cases; all were then undertaken surgical operation. Conclusion Air reduction for child intessusception with anisodamine is an easy and effective method ought to be recommanded.

The Diagnositc Air Enema Treatment in Childhood with Acute Intussusception (An Analysis of 198 Cases) / 实用放射学杂志

Objective To study the influence factors of gas enema reduction intussusecption and increase the reduction success rate.Methods The authors retrospectively reviewed the acute intussusception of 198 cases(200 attempts)in childhood treated by automatic intussusception reductor,and exerted by massage with hand .Statistical analysis and discussion were made between reduction success rate and disease duration,the position of apex of intussusception,systemic situation and methods.Results Of 198 cases,ileocolonic intussusception 160 patients(80.8%),Cecocolic intussusception 21 patients(10.6%),colocolonic intussusecption 17 patients(8.6%),air enema reduction rate was 83% overall in childhood with acute intussusception.Statistical analysis indicated that the successful rate of reduction came down by degreess of the intussusception along with the disease duration and from near to far of the location of intussusception.The results were compared using X 2 test (?

A Comparison of Air Reduction and Operation in Childhood Intussusception

PURPOSE: Intussusception is one of the most common cause of childhood intestinal obstructions. Early diagnosis is essential to avoid treatment delays, which can increase morbidity and mortality. METHODS: In order to evaluate the factors contributing to air-reduction failure, we reviewed cases of childhood intussusception admitted via the ER and managed by air enema reduction from 1994 to 1998. They were divided into two groups and compared retrospectively by using medical records. Group I was the operation group after air-reduction failure, and group II was the air-reduction group. RESULTS: In 319 cases (279 patients), group I consisted of 112 cases (110 patients), and group II consisted of 207 cases (169 patients). No differences in age, sex, body weight, location of intussusception, laboratory findings (leukocytosis and thrombocytosis), presence of bloody stool, and body temperature were noted between the two groups. Factors significantly contributing to air-reduction failure were duration of symptoms, type of intussusception and a few physical findings (abdominal distension, palpable mass, lethargy, and vomiting). The recurrence rate of group I was significantly lower than that of group II, and most recurrences developed in the first postoperative month. CONCLUSION: Childhood intussusceptions of a non-ileocolic type with longer durations of symptoms and severe clinical findings have a higher chance of air-reduction failure.

Air Pressure Enema Reduction in Infant and Childhood Intussusception

Reduction of intussusception using air or oxygen has wide acceptance as an alternative to conventional hydrostatic reduction. This study was undertaken to evaluate the results and complications of air pressure enema in 948 pediatric intussusception. One hundred and twenty nine cases had been operated because of the air reduction failure at the Department of Surgery, Masan Samsung Hospital from 1985 to 1996 were analysed. The success rate was 86.4%. Twenty-one patients (2.2%) showed perforation during air reduction. Risk factors of perforation were; age less than 3 months (42.9% vs 11.1%), duration of symtoms greater than 48 hours (66.7% Vs 33.3%), and presence of pathologic leading point (28.6% vs 3.7%). Vomitting and spontaneous rectal bleeding revealed higher prediction to the complication. In ninteen cases, pathoogy showed bowel infarction, coagulated necrosis and hemorrhage which suggest the cause of perforation tp to the preexisting strangulation. In conclusion, when doing an air pressure enema reduction, care must be taken to the young age as well as long duration gruop.

Clinical study of intussusception in infancy and childhood: comparing the result of barium enema with that of air enema

Intussusception is the most common cause of acquired intestinal obstruction during infancy and early childhood and requires early diagnosis and treatment. We observed 431 cases of intussusception who admitted at Chungang Gil Hospital from January 1987 to June 1991, and compared the result of treatment with Barium Enema in 302 cases with that of Air Enema in 129 cases. The results were as follows; 1) In sex distribution, males were more affected than females as a ratio of 2:1. 2) In age incidence, 78.2% of the cases were between 3~10 months. 3) Slight seasonal prevalence was noted in spring and autumn. 4) The common symptoms and signs were cyclic irritability (89.1%), vomiting (78.9%), bloody stool (84.9%) and abdominal mass(43.1%). 5) The common diseases accompanied were URI (39.7%), AGE (13.0%) and UTI(1.2%). 6) 5.8% of cases were visited after the 48 hours of symptom onset, in these cases the operation rate was 39.1%. So the longer duration of symptoms persists, the lower reduction rate follows. 7) The most common type of intussusception was ileocolic type, and the lowest reduction rate was noted in ileoileocolic type. 8) In the reduction rate, 87.4% with Barium Enema and 89.1% with Air Enema. 9) After 24 hours of symptom onset, the reduction rate, 74.4% with Barium Enema and 78.6% with Air Enema. 10) Recurrence rate was 9.3% with Barium Enema and 7.8% with Air Enema. 11) In Barium Enema, 1 case of bowel perforation was observed, and he expired with barium peritonitis, in Air Enema, 2 cases of bowel perforation were observed, and cured after operation. 12) We observed some advantages in Air Enema such as simplicity, high reduction rate and absence of fatal complications. And we think that Air Enema is a useful diagnstic and treatment method of intussusception.