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External manual reduction of paediatric idiopathic ileocolic intussusception with US assistance: a new, standardised, effective and safe manoeuvre

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Abstract

Background

The ultimate goal in the management of paediatric ileocolic intussusception is to achieve non-operative reduction and therefore patient cure. The standard non-surgical treatment consists of enema (air or liquid media).

Objective

The purpose of this study is to present external manual reduction for paediatric ileocolic intussusception. We present a new manoeuvre that is standardised, simple, safe and effective for the radiologist in the non-surgical management of this pathology.

Materials and methods

External manual reduction is performed under sedation. Execution of the manoeuvre is detailed and illustrated. The procedure was carried out 15 times in 13 paediatric patients with idiopathic ileocolic intussusception.

Results

Complete reduction exclusively by external manual reduction was accomplished on 12 occasions (80%). In the remaining three procedures, partial reduction to the cecum was obtained. Subsequent enema achieved complete reduction in two. Overall non-surgical reduction rate was 93%.

Conclusion

External manual reduction is a radiation-free, safe and effective procedure. In case of incomplete reduction, it facilitates enema performance. External manual reduction incorporates and additional initial step in the non-surgical reduction of intussusception and should be considered a first-line procedure.

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Authors and Affiliations

  1. Department of Radiology, Complejo Hospitalario Universitario de Vigo, Rúa de Pizarro 22, Vigo, Spain, 36204

    Jose L. Vazquez

  2. Department of Pediatrics, Complejo Hospitalario Universitario de Vigo, Vigo, Spain

    Manuel Ortiz

  3. Department of Anesthesiology, Complejo Hospitalario Universitario de Vigo, Vigo, Spain

    Maria C. Doniz

  4. Department of Pediatric Surgery, Complejo Hospitalario Universitario de Vigo, Vigo, Spain

    Margarita Montero

  5. Department of Public Health, Complejo Hospitalario Universitario de Vigo, Vigo, Spain

    Victor M. del Campo

Authors
  1. Jose L. Vazquez
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  2. Manuel Ortiz
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  3. Maria C. Doniz
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  4. Margarita Montero
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  5. Victor M. del Campo
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Corresponding author

Correspondence to Jose L. Vazquez.

Additional information

This paper was honored with the Jacques Lefebvre Award at the 2012 ESPR meeting in Athens.

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Vazquez, J.L., Ortiz, M., Doniz, M.C. et al. External manual reduction of paediatric idiopathic ileocolic intussusception with US assistance: a new, standardised, effective and safe manoeuvre. Pediatr Radiol 42, 1197–1204 (2012). https://doi.org/10.1007/s00247-012-2424-0

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  • DOI: https://doi.org/10.1007/s00247-012-2424-0

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