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Seasonal Variations and Different Treatment Protocols OF Intussusception In Children:

Зөвхөн бүртгэлтэй хэрэглэгчид л нийтлэл орчуулах боломжтой
Нэвтрэх / Бүртгүүлэх
Холбоосыг санах ойд хадгалдаг
СтатусДууссан
Ивээн тэтгэгчид
Minia University

Түлхүүр үгс

Хураангуй

Background: Intussusception remains a common cause of bowel obstruction in children and results in significant morbidity and mortality if not promptly treated. There is a paucity of prospective studies regarding childhood intussusception. This study describes the seasonal variation and management outcomes of childhood intussusception.
METHODS: This was A prospective study of all patients admitted and treated for childhood intussusception aged < 12 year intussusception from January 2014 to December 2018 was conducted in El-Minia University Pediatric surgery unit. Data about the ages of the patients, sex, clinical presentation, duration of symptoms before presentation, mode of treatment, outcome of treatment, and incidence of recurrence were recorded and analyzed.

Тодорхойлолт

A prospective study from January 2014 to December 2018 was conducted in 470 cases in El-Minia University Pediatric surgery unit. All pediatric patients (up to 14 years old) hospitalized with diagnosis of bowel intussusception were included in the study. The clinical records included: age, gender, signs, symptoms, and number of any previous episodes of intussusception and their treatment, concomitant pathologies and intolerance, ultrasound data, laboratory parameters and performed treatment.

An ultrasonography was performed when patients presented suspicion symptoms and signs of intussusception, in order to confirm the diagnosis and exclude other causes. Diagnosis was based on the presence of the "target sign" on vertical section on ultrasound images. Collected data included location and diameter of the intussusception, free fluid in abdomen and presence of visible pathological lead point. If diagnosis was confirmed, the management and treatment depended on the patients' situation, in patients complaining of severe dehydration, high grade fever and other signs of septicemia the conservative treatment was contraindicated and direct surgical treatment was performed. For children in good general conditions initial Pneumatic reduction under continuous imaging monitoring using a C-arm device was attempted; if reduction failed or unstable vital signs were observed, enema was discontinued and surgical management was proposed. If intussusception recurrence was observed in the next hours, Pneumatic reduction was performed again whenever possible.

Treatment After fluid and electrolyte correction, Pneumatic reduction was performed by using air through an 18 F urinary catheter applied to the rectum under continuous imaging guidance by C-arm. With child in a supine position, a Foley catheter was introduced in the rectum and maintained by inflating its balloon with 40 ml saline; the buttocks were joined with a band aid in order to avoid leaks. The rectal cannula was connected to Sphygmomanometer inflatable cuff initially about 80 mmHg increasing up to a maximum of 120. The passage of air into the ileum through the ileocecal valve ensures successful reduction. No time limit was imposed on the duration of the procedure; however, cessation of retrograde movement of the intussusception for more than 15 minutes was regarded as a failed attempt. The procedure was repeated 20 minutes later, with a maximum of 3 attempts.

All children were kept under medical supervision, no oral intake was permitted for the following 24 hours and intravenously fluids and antibiotics were given. After 12 to 24 hours ultrasonography was repeated to exclude early recurrence.

Огноо

Сүүлд баталгаажуулсан: 06/30/2020
Эхлээд оруулсан: 06/27/2020
Тооцоолсон элсэлтийг оруулсан: 07/21/2020
Эхлээд нийтэлсэн: 07/23/2020
Сүүлийн шинэчлэлтийг оруулсан: 07/21/2020
Сүүлийн шинэчлэлтийг нийтэлсэн: 07/23/2020
Сургалтын бодит эхлэх огноо: 01/13/2014
Тооцоолсон анхан шатны ажил дуусах огноо: 12/12/2018
Судалгааны ажлыг дуусгах өдөр: 03/06/2020

Нөхцөл байдал эсвэл өвчин

Intussusception

Хөндлөнгийн оролцоо / эмчилгээ

Procedure: Intervention

Үе шат

-

Arm Groups

ГарХөндлөнгийн оролцоо / эмчилгээ
No Intervention: Season of presentation
Comparison of number of presented cases in each season
Active Comparator: Intervention
Surgical intervention of failed Pneumatic cases is done
Procedure: Intervention
Pneumatic reduction is the main intervention for suitable cases and If failed a laparotomy exploration and surgical reduction is done to save life

Эрхийн шалгуур

Суралцах боломжтой нас 18 Months Хэнд 18 Months
Суралцах боломжтой хүйсAll
Эрүүл сайн дурын ажилтнуудыг хүлээн авдагТийм ээ
Шалгуур үзүүлэлтүүд

Inclusion Criteria:

- All patients in the pediatric age group (<14 years).

- Proved diagnosis of acute intussusception.

- Completion of patient's data in the medical records.

Exclusion Criteria:

- Other concomitant disease.

- Refused cases

Үр дүн

Анхан шатны үр дүнгийн арга хэмжээ

1. Time of presentation [2 years]

Seasons with high presented cases

Хоёрдогч үр дүнгийн арга хэмжээ

1. Surgery [2 Years]

If we needed Invasive Intervention or Classic reduction

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