PROGNOSTIC FACTORS FOR FAILED PNEUMATIC REDUCTION IN CHILDREN WITH INTUSSUSCEPTION AT CAN THO CHILDREN'S HOSPITAL

Thuy Doan Lam1,, Diep Hai Duong Le1, Thi Thanh Xuan Le1, Quoc Bao Tran1, Vo Thuy Anh Ngo1, Quang Huy Vo1
1 Can Tho University of Medicine and Pharmacy

Main Article Content

Abstract

Background: Pneumatic reduction in the intussusception's treatment has a high success rate, but there are still a few cases of failure that requiring surgery. The predictors of failed reduction are still being discussed and hematochezia is one of them. Objectives: To determine the proportion of hematochezia, identify the prognostic factors for failed pneumatic reduction of intussusception. Materials and methods: A cross-sectional descriptive prospective study was used for the children <15 age of intussusceptions who were diagnosed and treated with pneumatic reduction at Can Tho Children’ s Hospital from 07/2021 to 09/2022. Results: A total 162 childrens were included in the study, including 86 males (53.1%), the male/female ratio was 1.13/1. The mean age was 24.3 ± 14 months. The mean weight was 11.6 ± 3.7 kg. The rate of hematochezia was 22.2%. The rate of children hospitalized <24 hours accounted for 54.3%. The success rate of pneumatic reduction was 95.7%. Prognostic factors for failed pneumatic reduction include: age ≤ 24 months, body weight ≤10 kg, palpable mass, hematochezia, classical triad of intussusception, and presence of trapped fluid on ultrasound. Conclusions: Pediatric patient is diagnosed with intussusception; it is important to consider the prognostic factors for failed pneumatic reduction and to prevent to avoid severe complications.

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References

1. Emily A Edwards, Nicholas Pigg, Jesse Courtier, Matthew A. Zapala, John D. MacKenzie et al. Intussusception: past, present, and future. Pediatric radiology. 2017. 47, 1101-1108. https://doi.org/10.1007/s00247-017-3878-x.
2. Andrew D Clark et al. Update on the global epidemiology of intussusception: a systematic review of incidence rates, age distributions and case-fatality ratios among children aged < 5 years, before the introduction of rotavirus vaccination. International journal of epidemiology. 2019 48(4), 1316-1326, https://doi.org/10.1093/ije/dyz028.
3. Tạ Vũ Quỳnh, Nghiên cứu đặc điểm lâm sàng, siêu âm, đánh giá kết quả và tìm hiểu một số yếu tố ảnh hưởng đến kết quả tháo lồng ruột bằng hơi ở trẻ em tại Bệnh viện Nhi Đồng Cần Thơ 2017-2018. Tạp chí Y Dược học Cần Thơ. 2018. 16, 1-7.
4. Hồ Hữu Thiện. Nghiên cứu các yếu tố xác định tháo lồng bằng phẫu thuật ở trẻ em dưới 2 tuổi bị lồng ruột cấp. Tạp chí Y học Lâm sàng. 2020. 59, 26-33, DOI: 10.38103/jcmhch.2020.59.4.
5. Jiraporn Khorana and Jayanton Patumanond. Prognostic indicators for failed nonsurgical reduction of intussusception. Therapeutics and Clinical Risk Management. 2016. 12, 12311237. DOI: 10.2147/TCRM.S109785.
6. Jiajie Hu, Miaoqing Liu, Xiangbo Yu, Qiongzhang Xia, Ke Wang et al. Clinical characteristics of intussusception with surgical reduction: a single-center experience with 568 cases. Journal of Gastrointestinal Surgery. 2019. 23, 2255-2262. https://doi.org/10.1007/s11605-019-04178-0.
7. Hui-Ya Huang, Xiao-Zhong Huang, Yi-Jiang Han, Li-Bin Zhu, Kai-Yu Huang et al. Risk factors associated with intestinal necrosis in children with failed non-surgical reduction for intussusception. Pediatric surgery international. 2017. 33, 575-580. https://doi.org/10.1007/s00383-017-4060-0.
8. Aoki Yoshihiro, Iguchi Akihiro, Kitazawa Katsuhiko, Kobayashi Hironobu, Senda Masayoshi et al. Differences in clinical findings based on the duration of symptoms and age of children with ileocolic intussusception: a single-institution survey in rural Japan. Pediatric Emergency Care. 2021. 37(11), 537-542. DOI: 10.1097/PEC.0000000000001750.
9. Xie Xiaolong, Yang W, Qi W, Yiyang Z, Bo X. Risk factors for failure of hydrostatic reduction of intussusception in pediatric patients: A retrospective study. Medicine (Baltimore). 2019. 98(1). DOI: 10.1097/MD.0000000000013826.
10. Trần Tấn Lộc. Đánh giá các yếu tố tiên lượng tháo lồng bằng hơi thất bại trong bệnh lồng ruột ở trẻ em. Tạp chí Y học Việt Nam. 2019. 511, 49-53.
11. Richard A Steadman, Michael J. Harling, Michael J. Thomason, Katrina M. Morgan, Allison L. Hale et al. Initial Fluid Resuscitation Increases Risk of Failed Pneumatic Reduction of Intussusception. The American Surgeon. 2018. 84(11), 498-501. https://doi.org/10.1177/000313481808401122.
12. In Kyu Park and Min Jeng Cho. Clinical characteristics according to age and duration of symptoms to be considered for rapid diagnosis of pediatric intussusception. Frontiers in Pediatrics. 2021. 9, 651297. https://doi.org/10.3389/fped.2021.651297.
13. Meraj N Ondhia, Yousef Al-Mutawa, Srikrishna Harave, Paul D. Losty. Intussusception: A 14year experience at a UK tertiary referral centre. Journal of Pediatric Surgery. 2020. 55(8), 1570-1573. https://doi.org/10.1016/j.jpedsurg.2019.07.022.
14. Indrastuti Normahayu, Whenny Pramusinta, Widanto, Sri Andarini and Yuyun Yueniwati. The presence of trapped fluid on ultrasound as high predictive value for intestinal necrosis in pediatric intussusception. GSC Advanced Research and Reviews. 2021. 8(1), 053-059. https://doi.org/10.30574/gscarr.2021.8.1.0142.