Indian journal of pediatrics · 2025
Clinical Determinants of Unsuccessful Ultrasound-Guided Hydrostatic Saline Reduction in Children with Intussusception Post-Rotavirus Vaccine Introduction: Insights from a Tertiary Care Centre in Thrissur, Kerala, India.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Namboodiripad Aparna, Xavier Rose, Chaudhary Varsha Sudhir, Lingam Ragavi, George Gibi, Thuruthiyath Nithya, Alappat Meera Mary, Machathi Anupama, Kharat Namrata
Аннотация
OBJECTIVES: Intussusception (IS) is a condition in which proximal segment of the bowel invaginates into its distal segment. IS in young children can usually be managed using non-invasive methods, such as hydrostatic saline reduction (HSR), and surgery is generally reserved for cases in which non-invasive methods have failed. This study was conducted as part of a larger multicenter IS surveillance study. The objective of this analysis was to identify clinical and demographic factors associated with failed HSR in children hospitalized with IS.
METHODS: In this observational study, children aged < 2 y hospitalized with IS confirmed according to the Brighton Collaboration criteria at a tertiary care center in Kerala were enrolled after obtaining parental informed consent. Children who underwent spontaneous reduction were excluded. Enrolled children were followed up until discharge.
RESULTS: Of the 137 children who underwent HSR, 131 (95.6%) procedures were successful. HSR failed in six children (4.4%), and they required surgery; however, there were no deaths. The factors associated with failed HSR included low socioeconomic status [83% (5/6) vs. 32.1% (42/131); p = 0.042], a left-sided mass detected on ultrasonography [50% (3/6) vs. 6.9% (9/131); p = 0.004], and longer time from admission to the procedure (median: 5.5 vs. 3 h; p = 0.005).
CONCLUSIONS: This study demonstrates the importance of early HSR and exercising caution when a left-sided mass is detected on ultrasonography. With timely intervention, almost all cases can be successfully managed without surgery.
METHODS: In this observational study, children aged < 2 y hospitalized with IS confirmed according to the Brighton Collaboration criteria at a tertiary care center in Kerala were enrolled after obtaining parental informed consent. Children who underwent spontaneous reduction were excluded. Enrolled children were followed up until discharge.
RESULTS: Of the 137 children who underwent HSR, 131 (95.6%) procedures were successful. HSR failed in six children (4.4%), and they required surgery; however, there were no deaths. The factors associated with failed HSR included low socioeconomic status [83% (5/6) vs. 32.1% (42/131); p = 0.042], a left-sided mass detected on ultrasonography [50% (3/6) vs. 6.9% (9/131); p = 0.004], and longer time from admission to the procedure (median: 5.5 vs. 3 h; p = 0.005).
CONCLUSIONS: This study demonstrates the importance of early HSR and exercising caution when a left-sided mass is detected on ultrasonography. With timely intervention, almost all cases can be successfully managed without surgery.