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Hydrostatic reduction of intussusception with intermittent radiography: an alternative to fluoroscopy or ultrasound-guided reduction in low-income and middle-income countries
BACKGROUND: Although hydrostatic reduction of intussusception with ultrasound (US) or fluoroscopy guidance is well known, it is not yet well established in many low-income and middle-income countries. The aim of the study is to report our results of hydrostatic reduction with intermittent radiograph...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9717362/ https://www.ncbi.nlm.nih.gov/pubmed/36474637 http://dx.doi.org/10.1136/wjps-2020-000221 |
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author | Chowdhury, Tanvir Kabir Ahsan, Md. Qumrul Chowdhury, Mohammad Zonaid Chowdhury, Md. Tameem Shafayat Imam, Md. Sharif Alam, Md. Afruzul Farooq, Md. Abdullah Al |
author_facet | Chowdhury, Tanvir Kabir Ahsan, Md. Qumrul Chowdhury, Mohammad Zonaid Chowdhury, Md. Tameem Shafayat Imam, Md. Sharif Alam, Md. Afruzul Farooq, Md. Abdullah Al |
author_sort | Chowdhury, Tanvir Kabir |
collection | PubMed |
description | BACKGROUND: Although hydrostatic reduction of intussusception with ultrasound (US) or fluoroscopy guidance is well known, it is not yet well established in many low-income and middle-income countries. The aim of the study is to report our results of hydrostatic reduction with intermittent radiography, which has the potential to be practiced in resource-limited settings. METHODS: We retrospectively analyzed our patients with intussusception from 2009 to 2019 (11 years). Hydrostatic reduction was performed using water-soluble contrast medium (iopamidol), and reduction was followed with intermittent X-rays taken after every 50 mL of diluted contrast injection. The procedure was not continuously monitored by US or fluoroscopy. Differences in outcome based on age and gender, and yearly trends of admission for intussusception, types of treatment and mortality were analyzed. RESULTS: Among 672 patients, the ratio of boys to girls was 2.46:1.0, and their ages ranged from 1 month to 15 years (median 8 months). Hydrostatic reduction was performed successfully in 351 (52.23%) patients; 308 (45.83%) patients underwent surgery; and 13 (1.93%) patients died before any intervention. There were significant differences in age between patients with successful hydrostatic reduction (median 7 months) and patients needing surgery (median 9 months) (p<0.001). The number of successful hydrostatic reductions increased during the 11 years of the study (R(2)=0.88). One patient (0.15%) died after hydrostatic reduction, and 10 (1.49%) died after surgery. CONCLUSION: Hydrostatic reduction with intermittent radiography was performed successfully in more than half of the patients with acceptable complication rates. |
format | Online Article Text |
id | pubmed-9717362 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-97173622022-12-05 Hydrostatic reduction of intussusception with intermittent radiography: an alternative to fluoroscopy or ultrasound-guided reduction in low-income and middle-income countries Chowdhury, Tanvir Kabir Ahsan, Md. Qumrul Chowdhury, Mohammad Zonaid Chowdhury, Md. Tameem Shafayat Imam, Md. Sharif Alam, Md. Afruzul Farooq, Md. Abdullah Al World J Pediatr Surg Original Research BACKGROUND: Although hydrostatic reduction of intussusception with ultrasound (US) or fluoroscopy guidance is well known, it is not yet well established in many low-income and middle-income countries. The aim of the study is to report our results of hydrostatic reduction with intermittent radiography, which has the potential to be practiced in resource-limited settings. METHODS: We retrospectively analyzed our patients with intussusception from 2009 to 2019 (11 years). Hydrostatic reduction was performed using water-soluble contrast medium (iopamidol), and reduction was followed with intermittent X-rays taken after every 50 mL of diluted contrast injection. The procedure was not continuously monitored by US or fluoroscopy. Differences in outcome based on age and gender, and yearly trends of admission for intussusception, types of treatment and mortality were analyzed. RESULTS: Among 672 patients, the ratio of boys to girls was 2.46:1.0, and their ages ranged from 1 month to 15 years (median 8 months). Hydrostatic reduction was performed successfully in 351 (52.23%) patients; 308 (45.83%) patients underwent surgery; and 13 (1.93%) patients died before any intervention. There were significant differences in age between patients with successful hydrostatic reduction (median 7 months) and patients needing surgery (median 9 months) (p<0.001). The number of successful hydrostatic reductions increased during the 11 years of the study (R(2)=0.88). One patient (0.15%) died after hydrostatic reduction, and 10 (1.49%) died after surgery. CONCLUSION: Hydrostatic reduction with intermittent radiography was performed successfully in more than half of the patients with acceptable complication rates. BMJ Publishing Group 2021-01-14 /pmc/articles/PMC9717362/ /pubmed/36474637 http://dx.doi.org/10.1136/wjps-2020-000221 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Research Chowdhury, Tanvir Kabir Ahsan, Md. Qumrul Chowdhury, Mohammad Zonaid Chowdhury, Md. Tameem Shafayat Imam, Md. Sharif Alam, Md. Afruzul Farooq, Md. Abdullah Al Hydrostatic reduction of intussusception with intermittent radiography: an alternative to fluoroscopy or ultrasound-guided reduction in low-income and middle-income countries |
title | Hydrostatic reduction of intussusception with intermittent radiography: an alternative to fluoroscopy or ultrasound-guided reduction in low-income and middle-income countries |
title_full | Hydrostatic reduction of intussusception with intermittent radiography: an alternative to fluoroscopy or ultrasound-guided reduction in low-income and middle-income countries |
title_fullStr | Hydrostatic reduction of intussusception with intermittent radiography: an alternative to fluoroscopy or ultrasound-guided reduction in low-income and middle-income countries |
title_full_unstemmed | Hydrostatic reduction of intussusception with intermittent radiography: an alternative to fluoroscopy or ultrasound-guided reduction in low-income and middle-income countries |
title_short | Hydrostatic reduction of intussusception with intermittent radiography: an alternative to fluoroscopy or ultrasound-guided reduction in low-income and middle-income countries |
title_sort | hydrostatic reduction of intussusception with intermittent radiography: an alternative to fluoroscopy or ultrasound-guided reduction in low-income and middle-income countries |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9717362/ https://www.ncbi.nlm.nih.gov/pubmed/36474637 http://dx.doi.org/10.1136/wjps-2020-000221 |
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