Management of Intussusception: Follow-up or Reduction?

Ömer Katı; Şükrü Güngör; Yaşar Kandur; Ahmet Gökhan Güler

Article Details

Management of Intussusception: Follow-up or Reduction?

Authors:

Ömer Katı | Şükrü Güngör | Yaşar Kandur | Ahmet Gökhan Güler

Publisher:

Kahramanmaras Sutcu Imam University

Main Topics:

Sağlık Kurumları Yönetimi

Journal:

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi Vol.18 Issue 3, pp.37-40

Document Type:

Article

Publication Date:

11/2023

Document Language:

English

Document ID (Org No.):

2001303777

pISSN:

1303-6610

Keywords:

Abstract:

 Objective: In this study, we describe the management and outcome of children with intussusception and analyze the sonographic findings that can be used to differentiate transient, self-limited small bowel intussusception from the cases with an indication for surgery. Material and Methods: We retrospectively reviewed the medical records of pediatric patients with the diagnosis of invagination who had been followed up in the pediatric surgery service between 2012-2017. Results: The median age was 39.535.9 range 2-171 months. Among these patients, 57 64 had been followed up without surgery, and the remaining patients n 32, 36 had undergone surgery. The median age of patients who had not undergone surgery was significantly greater than that of the patients who had undergone surgery 52.238.4 vs. 16.7512.6; p0.001. Twenty 35.1 patients in the non-surgical group had developed abdominal pain after discharge, whereas none of the patients in the surgical group had developed abdominal pain postoperatively. An analysis of the differences between the groups with respect to the length of the invaginated segment revealed that length of that segment were significantly greater in the surgically managed cases p0.001. A ROC curve based on the length of the invaginated intestinal segment revealed that, 41.5 mm was the best cutoff point for invaginated intestinal length, which resulted in a sensitivity of 68.8 and a specificity of 96.5. Conclusion: In our study, unlike other studies, the surgical threshold of the invagination length was revised as 4.15 cm. Thus, patients below this value may not have an immediate indication for surgery.

 Objective: In this study, we describe the management and outcome of children with intussusception and analyze the sonographic findings that can be used to differentiate transient, self-limited small bowel intussusception from the cases with an indication for surgery. Material and Methods: We retrospectively reviewed the medical records of pediatric patients with the diagnosis of invagination who had been followed up in the pediatric surgery service between 2012-2017. Results: The median age was 39.535.9 range 2-171 months. Among these patients, 57 64 had been followed up without surgery, and the remaining patients n 32, 36 had undergone surgery. The median age of patients who had not undergone surgery was significantly greater than that of the patients who had undergone surgery 52.238.4 vs. 16.7512.6; p0.001. Twenty 35.1 patients in the non-surgical group had developed abdominal pain after discharge, whereas none of the patients in the surgical group had developed abdominal pain postoperatively. An analysis of the differences between the groups with respect to the length of the invaginated segment revealed that length of that segment were significantly greater in the surgically managed cases p0.001. A ROC curve based on the length of the invaginated intestinal segment revealed that, 41.5 mm was the best cutoff point for invaginated intestinal length, which resulted in a sensitivity of 68.8 and a specificity of 96.5. Conclusion: In our study, unlike other studies, the surgical threshold of the invagination length was revised as 4.15 cm. Thus, patients below this value may not have an immediate indication for surgery.

 Objective: In this study, we describe the management and outcome of children with intussusception and analyze the sonographic findings that can be used to differentiate transient, self-limited small bowel intussusception from the cases with an indication for surgery. Material and Methods: We retrospectively reviewed the medical records of pediatric patients with the diagnosis of invagination who had been followed up in the pediatric surgery service between 2012-2017. Results: The median age was 39.535.9 range 2-171 months. Among these patients, 57 64 had been followed up without surgery, and the remaining patients n 32, 36 had undergone surgery. The median age of patients who had not undergone surgery was significantly greater than that of the patients who had undergone surgery 52.238.4 vs. 16.7512.6; p0.001. Twenty 35.1 patients in the non-surgical group had developed abdominal pain after discharge, whereas none of the patients in the surgical group had developed abdominal pain postoperatively. An analysis of the differences between the groups with respect to the length of the invaginated segment revealed that length of that segment were significantly greater in the surgically managed cases p0.001. A ROC curve based on the length of the invaginated intestinal segment revealed that, 41.5 mm was the best cutoff point for invaginated intestinal length, which resulted in a sensitivity of 68.8 and a specificity of 96.5. Conclusion: In our study, unlike other studies, the surgical threshold of the invagination length was revised as 4.15 cm. Thus, patients below this value may not have an immediate indication for surgery.

 Amaç: Bu çalışmada, invajinasyon tanısı alan çocuk hastalarda ultrasonografik bulguların cerrahi yaklaşım ile sadece izlem yönetimi kararında etkinliğini analiz etmeyi amaçladık. Gereç ve Yöntemler: 2012-2017 yılları arasında çocuk cerrahisi servisinde izlenen invajinasyon tanılı çocuk hastaların tıbbi kayıtları geriye dönük olarak incelendi. Bulgular: Ortanca yaş 39.5  35.9 dağılım 2-171 aydı. Elli yedi  64 hasta takip edilmiş, geri kalan hastalar n  32,  36 ameliyat edilmişti. Ameliyat geçirmemiş hastaların ortanca yaşı ameliyat geçirenlere göre anlamlı olarak daha yüksekti 52.2  38.4e karşı 16.75  12.6; p 0.001. Ameliyatsız grupta 20 35.1 hastada taburcu olduktan sonra karın ağrısı gelişirken, ameliyat grubundaki hastaların hiçbirinde ameliyat sonrası karın ağrısı gelişmedi. İnvajine segmentin uzunluğu ameliyat edilen grupta anlamlı olarak daha fazla idi p0.001. İnvajinasyonlu bağırsak segmentinin uzunluğuna dayanan bir ROC eğrisi analizi,  68.8lik bir duyarlılık ve  96.5lik özgüllük ile 41.5 mm nin cerrahi sınır uzunluğu olduğunu ortaya koydu. Sonuç: Çalışmamızda önceki çalışmalardan farklı olarak invajinasyon uzunluğunun cerrahi eşiği 4,15 cm olarak revize edildi. Bu nedenle, bu değerin altındaki hastalarda ameliyat için acil bir endikasyon olmayabilir.

Article Details

Management of Intussusception: Follow-up or Reduction?

Authors:

Ömer Katı | Şükrü Güngör | Yaşar Kandur | Ahmet Gökhan Güler

Publisher:

Kahramanmaras Sutcu Imam University

Main Topics:

Sağlık Kurumları Yönetimi

Journal:

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi Vol.18 Issue 3, pp.37-40

Document Type:

Article

Publication Date:

11/2023

Document Language:

English

Document ID (Org No.):

2001303777

pISSN:

1303-6610

Intussusception

follow-up

ultrasonography

lengthİnvajinasyon

takip

ultrasonografi

uzunluk.

Issues

Article Details

Authors: Ömer Katı | Şükrü Güngör | Yaşar Kandur | Ahmet Gökhan Güler

Publisher: Kahramanmaras Sutcu Imam University

Main Topics: Sağlık Kurumları Yönetimi

Journal: Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi Vol.18 Issue 3, pp.37-40

Document Type: Article

Publication Date: 11/2023

Document Language: English

Document ID (Org No.): 2001303777

pISSN: 1303-6610

Issues

Authors:

Ömer Katı | Şükrü Güngör | Yaşar Kandur | Ahmet Gökhan Güler

Publisher:

Kahramanmaras Sutcu Imam University

Main Topics:

Sağlık Kurumları Yönetimi

Journal:

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi Vol.18 Issue 3, pp.37-40

Document Type:

Article

Publication Date:

11/2023

Document Language:

English

Document ID (Org No.):

2001303777

pISSN:

1303-6610