Journal of pediatric surgery · 2025
Successful Treatment of Early Presenting Intussusception With a Single Dose of Corticosteroid: A Prospective Randomized Controlled Trial.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Acer-Demir Tuğba, Gültekingil Ayşe, Fakıoğlu Ender, Güney Lütfi Hakan, Sezer Rahime
Аннотация
INTRODUCTION: To evaluate and compare the success rates of follow-up versus a single dose of corticosteroid (methylprednisolone) treatment in early-diagnosed intussusception cases to achieve resolution without the need for hydrostatic or pneumatic reduction and surgery.
METHODS: This study was conducted as a prospective randomized controlled trial. Patients aged 0-4 years, admitted to the Pediatric Emergency Department with a history of symptoms less than 24 h diagnosed with intussusception by ultrasound were randomly assigned to two groups. The treatment group received a single intravenous dose of 1 mg/kg methylprednisolone, while the control group was followed without medication. Follow-up ultrasound was performed at a median of 4 h.
RESULTS: The study included 60 patients in the steroid treatment group and 32 patients in the control group, with male-to-female ratio of 47:45 and a mean age of 28.3 ± 12.0 months. Ileoileal intussusceptions were more common in the control group (19/32, 59.4 %), while ileocolic intussusceptions were more frequent in the treatment group (22/60, 36.7 %) (p = 0.023). Steroid treatment was successful in 49 of 60 cases (81.7 %), whereas follow-up was successful in 18 of 32 cases (56.3 %). Overall, steroid treatment was significantly more successful (p = 0.009). For ileocolic intussusceptions, steroid treatment was successful in 17 of 22 cases (77.3 %), compared to 2 of 9 cases (22.2 %) in the control group (p = 0.012).
CONCLUSIONS: Single-dose steroid treatment is particularly effective for ileocolic intussusceptions presenting within 24 h. Steroid treatment may also be considered for unresolved ileoileal intussusception cases after initial follow-up. The clinical trial registration number is NCT05640375 (clinicaltrials.gov).
METHODS: This study was conducted as a prospective randomized controlled trial. Patients aged 0-4 years, admitted to the Pediatric Emergency Department with a history of symptoms less than 24 h diagnosed with intussusception by ultrasound were randomly assigned to two groups. The treatment group received a single intravenous dose of 1 mg/kg methylprednisolone, while the control group was followed without medication. Follow-up ultrasound was performed at a median of 4 h.
RESULTS: The study included 60 patients in the steroid treatment group and 32 patients in the control group, with male-to-female ratio of 47:45 and a mean age of 28.3 ± 12.0 months. Ileoileal intussusceptions were more common in the control group (19/32, 59.4 %), while ileocolic intussusceptions were more frequent in the treatment group (22/60, 36.7 %) (p = 0.023). Steroid treatment was successful in 49 of 60 cases (81.7 %), whereas follow-up was successful in 18 of 32 cases (56.3 %). Overall, steroid treatment was significantly more successful (p = 0.009). For ileocolic intussusceptions, steroid treatment was successful in 17 of 22 cases (77.3 %), compared to 2 of 9 cases (22.2 %) in the control group (p = 0.012).
CONCLUSIONS: Single-dose steroid treatment is particularly effective for ileocolic intussusceptions presenting within 24 h. Steroid treatment may also be considered for unresolved ileoileal intussusception cases after initial follow-up. The clinical trial registration number is NCT05640375 (clinicaltrials.gov).