Study on Factors Affecting Successful Outcome of Ultrasound Guided Hydrostatic Reduction of Ileocolic Intussusception in Children

Objectives: The present study was to determine what all factors are responsible for favourable outcome of USG guided hydrostatic reduction of ileocolic intussusception. Methods: Pre-warmed normal saline (warmed to body temperature, 36.5 – 37.5°C) was introduced via catheter into the rectum and proximal colon by hanging the bottle 120 cms above table height and allowing free flow under gravity. During the procedure, the retrograde movement of saline and the regress of intussusceptum were continuously monitored under real time ultrasound guidance. Besides, the peritoneal cavity was scanned intermittently in order to detect sudden increase in fluid and simultaneous depletion of fluid from the colon, suggesting bowel perforation. A maximum of 3 attempts were permitted, each attempt lasting 3 to 5 min with a gap of less than 3 min between the attempts. After failed third attempt, the procedure was ended without delay and the patient shifted urgently to the operation theatre for surgical reduction or resection with end- to-end bowel anastomosis. Patients who underwent successful USGHR were subsequently kept in the ward and observed for a minimum period of 24 hours to detect any complication. Results: The mean age of the patients were 3.61 years. The highest proportion of cases been observed in male category (64.7%) followed by females (35.3%). USG guided hydrostatic reduction was attempted in 50 cases and not attempted in 1 case. USG guided hydrostatic reduction distribution which was successful with complete reduction in 1st sitting in 48 cases and partial reduction in 2 cases which were then taken up for the 2nd sitting and were completely reduced. Mean time taken for completion of the procedure was 04:23 minutes. Mean quantity of NS used during the procedure was 2.97 Litres. Conclusions: Children who are diagnosed with intussusception early generally have a higher rate of effective hydrostatic reduction compared to those who are diagnosed later. Ultrasound- guided hydrostatic reduction is a highly effective and safe method for treating intussusception, making it the chosen initial treatment for suitable individuals. The success rate gained was exceedingly high.