Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Intussusception”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 523 records · Page 29Linked to original sources
PubMed2003

Intussusception. Part 3: Diagnosis and management of those with an identifiable or predisposing cause and those that reduce spontaneously.

In the previous two parts of this review on intussusception, the diagnosis and management of symptomatic, "idiopathic" ileocolic and ileoileocolic intussusceptions, which are considered to result from hyperplasia of lymphoid tissue in the distal ileum, were discussed. In this third part, those intussusceptions with an identifiable cause including pathologic lead point, those due to gastrojejunostomy or other feeding tubes, and those that are seen in the postoperative period as well as those that may be asymptomatic or may reduce spontaneously (usually limited to the small bowel) are discussed.

Causality↗
PubMed2003

Intussusception. Part 2: An update on the evolution of management.

Children with symptomatic ileocolic or ileo-ileocolic intussusceptions can be successfully managed in one of a number of different ways. The nonoperative enema reduction technique has major advantages over surgical reduction and high success rates can be achieved using pneumatic or hydrostatic reduction techniques under fluoroscopic or sonographic guidance. This article highlights current concepts and some controversial issues related to management of intussusception, including patient selection for attempted enema reduction, the advantages and disadvantages of each technique, complications, the value of delayed, repeated reduction attempts, the role of imaging after attempted enema reduction, and recurrence of intussusception.

Enema↗
PubMed2003

Intussusception in children: can we rely on screening sonography performed by junior residents?

BACKGROUND: Ultrasonography is an important tool in the screening and diagnosis of patients with suspected intussusception. OBJECTIVE: To retrospectively evaluate the accuracy and performance of junior residents and compare it to that of senior residents and staff radiologists. MATERIALS AND METHODS: Between January 1999 and February 2003, 151 patients with suspected intussusception underwent screening US. The mean age of the patients was 13.8 months. Patients were divided into three groups according to examiner: staff radiologist, senior resident or junior resident. RESULTS: Sixty-five patients had both US and air enema. Forty-four patients had a positive US result; 37 (84%) were true positive and 7 (16%) were false positive. Twenty-one patients had a negative US result; 18 (86%) were true negative and 3 (14%) were false negative. Eighty-six patients underwent screening US only and were then kept under observation in the emergency room. They were all diagnosed as having a non-surgical condition. The total accuracy rate was 93%, sensitivity was 84%, specificity was 97%, positive predictive value was 93% and negative predictive value was 94%. Accuracy rate, sensitivity and specificity were 92%, 85% and 98% for staff radiologists, 94%, 75% and 96% for senior residents and 95%, 83% and 97% for junior residents, respectively. CONCLUSIONS: Junior residents perform as well as staff radiologists in screening US for suspected intussusception and have gained both the respect and confidence of the paediatricians.

Child, Preschool↗
PubMed2004

Jejunal intussusception in a 10-year-old boy with blue rubber bleb nevus syndrome.

Jejunal intussusception in a Chinese 10-year-old boy affected by the blue rubber bleb nevus syndrome is presented and discussed. The syndrome is rare, sporadically found with possible dominant inheritance, and due to a gene mutation mapped on the short arm of chromosome 9. It presents with distinctive cutaneous and gastrointestinal malformations together with possible other organ involvement. Gastrointestinal malformations tend to bleed and lead to anaemia. Infrequent complications of the gastrointestinal malformations are volvulus, intestinal infarction and intussusception. The age of the patient and the jejunal intussusception precipitated by a vascular malformation containing calcifications (which were also found in different gut segments) make this case remarkable.

Child↗
PubMed1999

Ultrasound features of intussusception predicting outcome of air enema.

OBJECTIVE: To examine features identified on US which predict success or failure of air-enema reduction of intussusception. MATERIALS AND METHODS: A retrospective study of 117 consecutive episodes of intussusception, presenting for US over a 6-year period. The specific features examined were: free fluid within the peritoneum, small-bowel obstruction, colonic wall thickness, and fluid trapped between the colon and the intussusceptum. RESULTS: The overall reduction rate, irrespective of US features, over the 6-year period was 72 %. Reduction rates were significantly higher with the absence of free fluid, trapped fluid, or small-bowel obstruction (93 %). The presence of trapped fluid predicted an unfavourable outcome, with a significantly lower success rate (25 %). Colonic wall thickness did not predict outcome; in successful reductions, mean wall thickness was 7.2 mm and in failed reductions 7.6 mm. CONCLUSIONS: Where free fluid, small-bowel obstruction, and trapped fluid are absent, almost 100 % success with air-enema reduction should be achievable. Where trapped fluid is present, air enema should be performed cautiously to avoid perforation caused by overvigorous attempts at pneumatic reduction of an incarcerated intussusception.

Air↗
PubMed1999

Intestinal intussusception survey about diagnostic and nonsurgical therapeutic procedures.

OBJECTIVE: To provide an overview of the diagnostic and therapeutic procedures performed by European paediatric radiologists in the management of intussusception. MATERIALS AND METHODS: A postal survey was sent to the European members of ESPR. Items surveyed included diagnostic imaging procedures (plain films, US, contrast enema [CE]), contrast medium used (barium, iodine, air, saline solution), and imaging technique used for monitoring during reduction (films, fluoroscopy, US). Multiple answers were possible. Other data, including contraindications, maximum pressure, pressure and irradiation monitoring, presence of a surgeon, sedation, number and duration of attempts, and hospitalisation were also obtained and analysed. RESULTS: There were 204 respondents (60.2 %). Regarding diagnosis, 72.5 % of respondents used plain radiographs, 93 % US, and 34 % CE. Reduction was performed using air (55 %), a barium suspension (32 %), iodinated contrast medium (24 %), or a saline solution (10 %). Reduction was monitored using fluoroscopy alone (46 %), fluoroscopy and radiographs (49.5 %), US alone (9.5 %), or a combination of radiology and US (18 %). Pressure was monitored by 81 % of respondents. Most respondents (82.4 %) used a maximum pressure between 100 and 120 mm Hg. CONCLUSIONS: US is widely used for diagnosing intussusception. For treatment, contrast medium and air reduction are used almost equally. A large number of radiologists are now performing intussusception reduction using US monitoring.

Child↗
PubMedDate not supplied

Sonographic diagnosis of adult intussusception.

We describe three cases of adult intussusception in which ultrasonography provided the correct preoperative diagnosis. Patients underwent ultrasonography to investigate nonspecific acute abdominal pain; intussusception was not suspected. In all cases, the sonographic pattern was typical of intussusception and ultrasonography was the only diagnostic study. Bowel ischemia was not found at surgery in any patient.

Abdomen, Acute↗
PubMed2002

Small bowel intussusception in symptomatic pediatric patients: experiences with 19 surgically proven cases.

Nineteen cases of surgically proven symptomatic pediatric small bowel intussusceptions (SBI) were retrospectively reviewed. Clinical presentations included vomiting (89.5%), abdominal pain and/or irritable crying (89.5%), fever (52.6%), bloody stools (26.3%), palpable abdominal masses (15.8%), hematemesis (10.5%), jaundice (5.3%), and seizures (5.3%). The duration between symptom onset and hospitalization ranged between 20 and 336 hours (average 75.8 hours). Two patients with suspected appendicitis and small bowel obstruction were operated on promptly. Sonograms revealed target lesions (average diameter 2.9 cm) suggestive of intussusception in 13 out of 17 patients, with 10 lesions located in the paraumbilical or left abdominal regions. Barium enemas in 12 of these 13 patients demonstrated no colonic lesions. Diagnosis and surgery were delayed in 16 patients (average delay = 32 hours). The remaining 1 patient with positive sonographic findings underwent early surgery after computed tomographic (CT) confirmation of SBI. Surgery revealed ileoileal intussusceptions in 11 patients, jejunojejunal in 4, jejunoileal in 3, and duodenojejunal in 1. Eight patients had lead points. Bowel complications (ischemia, necrosis, or perforation) occurred in 8 patients. The duration between symptom onset and surgery in patients with bowel complications was significantly longer than for patients without complications (p = 0.0026). In conclusion, delayed diagnosis and surgical treatment in symptomatic pediatric patients with SBI were common, leading to a high rate (42%) of bowel complications. Sonographic demonstration of a 2-3 cm target lesion, especially if paraumbilical or left abdominal, is suggestive of SBI and may obviate the need for a barium enema; however, CT is helpful for confirming SBI. In symptomatic SBI, once diagnosed, early surgical referral is strongly recommended.

Adolescent↗
PubMedDate not supplied

Cecal-colic adult intussusception as a cause of intestinal obstruction in Central Africa.

During a 5-year experience in Central Africa, the most common cause of 78 adult intestinal obstructions was primary adult cecal-colic intussusception (n = 43; 55%). The symptom complex of colicky abdominal pain and obstipation was present in 100% of the patients with intussusception. Operative repair in 90% of patients consisted of simple reduction of the intussusceptum. There were no known recurrences. The etiology of adult cecal-colic intussusception is unknown. Patients typically present with a 3- to 4-day history of abdominal pain, obstipation, and usually a palpable mass. Treatment is surgical reduction. Right colectomy is reserved for intestinal gangrene. We treated 43 cases during a 5-year period with only one death.

Adolescent↗
PubMed1996

Intussusception in children: international perspective.

Fifty consecutive cases of children with intussusception treated at a hospital in a developing country were compared with 50 consecutive cases treated at an American inner city children's hospital and 50 consecutive cases treated at an American referral children's hospital. The plan was to recommend ways of improving the treatment of children with intussusception in the developing world. Nonoperative reduction was attempted in the two American hospitals but was not available in the developing world hospital where all children were treated operatively. Children in the developing world hospital had a significantly longer duration of symptoms, an increased incidence of nonviable bowel, and a mortality of 18%. There were no deaths in either American hospital. The poorer outcome for developing world children was related to delay in treatment, the higher incidence of nonviable bowel, and the lack of adequate nursing care for acutely ill children. The use of nonoperative reduction would not have significantly improved the mortality rate among the developing world children. The mortality can best be reduced by: (1) earlier recognition and treatment of the intussusception; and (2) improvement in the postanesthetic care with better monitoring leading to prompt recognition and treatment of postoperative complications.

Child↗
PubMed2004

Management of intussusception.

Intussusception represents the most common abdominal emergency in infancy. The classical clinical triad, consisting of abdominal colics, red jelly stools and a palpable mass, is only present in approximately 50% of cases, 20% of patients are symptom free at clinical presentation. Primary imaging modality of choice is ultrasound scanning, which enables the diagnosis or exclusion of an intussusception at a sensitivity of 98-100%, specificity of 88% and a negative predictive value of 100%. In emergency cases, additional plain films are necessary to detect potential intestinal perforation, to identify intestinal obstruction or other diseases mimicking the clinical presentation. Once the diagnosis of an intussusception is established, non-surgical reduction (NSR) is used. A surgical approach is chosen in patients with signs of perforation, shock or peritonitis. Depending on the choice of guiding imaging technique, different contrast media are used for NSR. Barium suspension or air with fluoroscopic guidance, or saline only or mixed with water-soluble contrast under sonographic guidance, has to be used. Regardless of the used contrast medium, NSR is an effective technique, being successfully employed in more than 90% of cases.

Abdomen, Acute↗
PubMed1998

Chronic intussusception in childhood.

A rare case of chronic intussusception is reported. Radiological investigation including ultrasound, CT and barium enema provided the correct diagnosis. Ultrasound revealed a solid mass near the transverse colon in the right lower abdomen. CT demonstrated the real nature of the solid mass as being the classical 'coiled spring' of intussusception. The barium enema was unsuccessful as an attempt at hydrostatic reduction, but confirmed the diagnosis by a 'crescent-shaped' filling defect in the ascending colon. The patient was discharged after an uneventful surgery and recovery. No organic lesion that precipitated the chronic intussusception was discovered at operation. Radiological findings, the typical clinical picture and adequate treatment are discussed.

Chronic Disease↗
PubMed2004

Ileal invagination of the sigmoid colon producing a sigmoidorectal intussusception combined with rectal prolapse in a 3-year-old child.

Intussusception is very common in children all over the world, especially those under 2 years. This can be ileoileal, ileocolic, or colocolic, i.e. the immediate proximal part of the intestine telescoping into the distal portion of the intestine. Ileosigmoid intussusception involves the invagination of a loop of the ileum into the sigmoid colon, producing two obstructions: that involving the invaginated loop of terminal ileum and that of the sigmoidorectal intussusception. This can lead to ischaemia and necrosis of either the ileum or sigmoid colon. The case presented here is suspected to be the first one reported in the world scientific literature.

Colon, Sigmoid↗
PubMed2005

Complex presentation of intussusception in childhood.

The simultaneous occurrence of intussusception and volvulus in the paediatric age group is rare. We report the case of a volvulus of an ileoileal intussusception in an 8-year-old boy. This is the first time that computerised tomography (CT) images of a volvulus of an ileoileal intussusception have been published, and they clearly demonstrate both pathologies. This case highlights the use of CT in determining the nature of an abdominal mass and demonstrates how helpful it can be in diagnosing the cause of small bowel obstruction in children.

Anastomosis, Surgical↗
PubMed2005

Combined ileal heterotopic pancreatic and gastric tissues causing ileocolic intussusception in an infant.

Pathological intussusception is rare in infancy with Meckel's diverticulum being the most common lesion. Isolated heterotopic pancreatic tissue in the serosa of the ileum causing intussusception is extremely rare. We report a case of ileal heterotopic pancreatic tissue associated with ectopic gastric mucosa causing ileocolic intussusception in an infant, with review of the literature.

Choristoma↗
PubMed2006

Intussusception in children: 11-year experience in Vladivostok.

Idiopathic intussusception is an important abdominal emergency in infancy and childhood. The nonoperative management by air enema has always been the standard of care in Russia. Our purpose is to assess our reduction rate and the rate of complications. We performed a retrospective analysis of all intussusception cases seen at the Department of Paediatric Surgery from 1994 to 2005. The data obtained included age, sex, clinical presentation, diagnostic procedures, mode of treatment, and results. Patients included 280 children from 1 month to 14 years of age. Eighty-one percent of children were under age 1 year old, 61% were boys. The duration of symptoms before treatment was less than 18 h in 65%, 18-24 h in 21%, and more than 24 h in 14% of patients. The successful reduction rate was 86.1%. One patient with a duration of symptoms more than 24 h experienced colon perforation. Thirty-nine patients underwent surgery and, among these, abnormalities in the intestinal wall required resection in 12 cases. An association between the duration of symptoms and the outcome of the non-surgical treatment was present; non-surgical reduction was successful in 97.3% in the group with the duration of symptoms less than 18 h, 86.4% in 12-24 h, and 33.3% in more than 24 h. Air enema is a safe and effective approach for uncomplicated intussusception reduction with a high success rate, but the duration of symptoms directly increases the complication rate.

Adolescent↗
PubMed1998

Manual reduction with the index finger for infantile intussusception. A modification of Hutchinson's maneuver.

Manual reduction with the index finger (modified Hutchinson's maneuver) enabling simple and safe manual reduction of infantile intussusception is described. The procedure was used in four patients, two boys and two girls, ranging in age from 2 to 15 months, as greater than normal compression was necessary and/or serosal splitting occurred during conventional reduction. The technique is as follows: in addition to the proximal bowel compression with Hutchinson's maneuver, the surgeon inserts his index finger into the intussusceptum via its neck. The finger enables the surgeon to sound a wider space between the intussusceptum and intussuscipiens, which is most likely to be responsive to bowel compression. Although the intussusceptions in the four patients were categorized as ileo-ileo-colic (three cases) and ileo-ileal (one case) types, this manual reduction technique was successful in all cases, no bowel rupture occurred, and hospitalization was no longer than with the conventional procedure. We conclude that this modified Hutchinson's maneuver may contribute to successful surgical reduction of infantile intussusception.

Female↗
PubMed1998

Reliability of color Doppler and power Doppler sonography in the evaluation of intussuscepted bowel viability.

In two similar cases of irreducible intussusception with wall necrosis and perforation, symptoms had begun 24 h before admission and the plain radiographs showed signs of small-bowel obstruction. The sonographic (US) appearances, however, were different: color Doppler (CD) US showed vascular flow in the intussuscepted bowel in one case and no flow in the other. After radio-clinical assessment, both children underwent surgery and an intestinal resection had to be performed, manual reduction being impossible. The reliability of the US findings and the prognostic value of CD and power Doppler US in determining the viability of the intussuscepted bowel are discussed with a review of the literature.

Anastomosis, Surgical↗