External manual reduction of paediatric idiopathic ileocolic intussusception with US assistance: a new, standardised, effective and safe manoeuvre.

28 de Abril de 2013 18:38

Pediatr Radiol. 2012 Oct;42(10):1197-204. doi: 10.1007/s00247-012-2424-0. Epub 2012 Aug 9. PubMed PMID: 22875204 Jose L. Vazquez, Manuel Ortiz, Maria C. Doniz, Margarita Montero, Victor M. del Campo Complejo Hospitalario Universitario de Vigo, Rúa de Pizarro 22, Vigo, Spain 36204 e-mail: Esta dirección de correo electrónico está siendo protegida contra los robots de spam. Necesita tener JavaScript habilitado para poder verlo. http://rd.springer.com/article/10.1007%2Fs00247-012-2424-0   This paper was honored with the Jacques Lefebvre Award at the 2012 ESPR meeting in Athens.   Abstract Background The ultimate goal in the management of paediatric ileocolic intussusception is to achieve non-operative reduction and therefore patient cure. The standard nonsurgical treatment consists of enema (air or liquid media). Objective The purpose of this study is to present external manual reduction for paediatric ileocolic intussusception.We present a new manoeuvre that is standardised, simple, safe and effective for the radiologist in the non-surgical management of this pathology. Materials and methods External manual reduction is performed under sedation. Execution of the manoeuvre is detailed and illustrated. The procedure was carried out 15 times in 13 paediatric patients with idiopathic ileocolic intussusception. Results Complete reduction exclusively by external manual reduction was accomplished on 12 occasions (80%). In the remaining three procedures, partial reduction to the cecum was obtained. Subsequent enema achieved complete reduction in two. Overall non-surgical reduction rate was 93%. Conclusion External manual reduction is a radiation-free, safe and effective procedure. In case of incomplete reduction, it facilitates enema performance. External manual reduction incorporates and additional initial step in the nonsurgical reduction of intussusception and should be considered a first-line procedure.

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