[Intussusception: barium vs. pneumatic reduction]. / Invaginación intestinal: Neumoenema versus enema de bario.

At the Hospital Niño Jesús air pressure enema has recently replaced the use of barium as treatment of choice in the reduction of intussusception. The purpose of this study was to review the air enema reductions done from June 1992 to February 1994 in 137 patients (group II) and to compare them with a previous series of 153 patients that underwent barium reduction treatment (group I). The groups were similar with regard to sex, age and presentins symptoms as well as clinical signs. Successful reduction was achieved in 131 patients (85.6%) out of 146 attempts treated with barium enema and in 124 patients (90.5%) out of 134 attempts treated with air enema. Among the unsuccessful reduction cases, operation was performed in 22 cases in group I and in 13 cases of group II. In the group I there were two perforations during the reduction attempt, while in group II we did not have any with the air enema. There were two recurrent intussusceptions following barium enema reduction and nine following air enema reduction in the first 48 hours. Patients treated with air enema stayed less days at hospital (1,6 days) than those treated with barium (3 days). We believe that the air enema treatment is easy to perform, is lower in cost and presents less morbility, and that it should be considered as the treatment of choice in the initial management of intussusception.

[Post-traumatic cholelithiasis]. / Colelitiasis postraumática.

A 5 year old patient, without any lithogenic antecedent, suffered a trauma, resulting in a shrunken fracture of the left parietal bone, and a splenic parenchymal hematoma. A hemoperitoneum developed at the 3rd postoperation day, with an overall blood loss of 15% of the total blood volume. At the 6th day a well formed biliary calculi was detected in the gallbladder. As the patient remain asymptomatic related to his cholelithiasis, an ultrasound follow-up was instituted. At 3 month postinjury all biliary stones dissolved completely. In this report, the etiopathogenic factors responsible of stone formation in the biliary tree, and current therapeutic recommendations are reviewed.