Pediatric Radiology

, Volume 47, Issue 12, pp 1594–1598 | Cite as

Assessment of a modified technique for air delivery during fluoroscopic-monitored pneumatic intussusception reduction

  • Gaurav Jindal
  • Brendon L. Graeber
  • Lawrence H. Staib
  • Cicero T. Silva
Original Article

Abstract

Background

Intussusception is one of the most common causes of acute abdominal emergency in children. Image-monitored pressure reduction is the first line of treatment.

Objective

We report on a modified technique of air delivery during fluoroscopic-monitored pneumatic intussusception reductions, and compare it with an established technique.

Materials and methods

We modified the Shiels intussusception reduction device so that the air used for intussusception reduction is delivered not by the device’s insufflator bulb, but rather by the hospital medical air supply system, eliminating the need for continuous pumping of the insufflator bulb during the procedure. Subsequently, we retrospectively compared sequential fluoroscopy-monitored pneumatic intussusception reduction procedures performed in patients younger than 18 years using either the standard or modified devices, evaluating technical procedure parameters (i.e. median procedure time length, fluoroscopy time length and radiation dose) and patient outcomes (i.e. number of complete intussusception reductions, number of incomplete intussusception reductions, number of intussusception recurrences within 3 days of the procedure, number of procedures followed by surgery).

Results

We found no statistically significant differences between procedures performed with the standard and modified techniques.

Conclusion

The device modification allows for increased operator comfort. Evaluated procedure parameters and patient outcomes appear similar to those of the standard technique.

Keywords

Air enema Children Device Fluoroscopy Intussusception 

Notes

Compliance with ethical standards

Conflicts of interest

None

References

  1. 1.
    Waseem M, Rosenberg HK (2008) Intussusception. Pediatr Emerg Care 24:793–800CrossRefPubMedGoogle Scholar
  2. 2.
    Stein-Wexler R, O'Connor R, Daldrup-Link H et al (2015) Current methods for reducing intussusception: survey results. Pediatr Radiol 45:667–674CrossRefPubMedGoogle Scholar
  3. 3.
    Guo JZ, Ma XY, Zhou QH et al (1986) Results of air pressure enema reduction of intussusception: 6,396 cases in 13 years. J Pediatr Surg 21:1201–1203CrossRefPubMedGoogle Scholar
  4. 4.
    Crystal P, Hertzanu Y, Farber B et al (2002) Sonographically guided hydrostatic reduction of intussusception in children. J Clin Ultrasound 30:343–348CrossRefPubMedGoogle Scholar
  5. 5.
    Gu L, Zhu H, Wang S et al (2000) Sonographic guidance of air enema for intussusception reduction in children. Pediatr Radiol 30:339–342CrossRefPubMedGoogle Scholar
  6. 6.
    Shiels WE 2nd, Bisset GS 3rd, Kirks DR et al (1990) Simple device for air reduction of intussusception. Pediatr Radiol 20:472–474CrossRefPubMedGoogle Scholar
  7. 7.
    Paterson CA, Langer JC, Somers S et al (1994) Pneumatic reduction of intussusception using carbon dioxide. Pediatr Radiol 24:296–297CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Gaurav Jindal
    • 1
    • 2
  • Brendon L. Graeber
    • 1
  • Lawrence H. Staib
    • 1
  • Cicero T. Silva
    • 1
  1. 1.Department of Radiology & Biomedical ImagingYale School of MedicineNew HavenUSA
  2. 2.Department of Diagnostic ImagingBrown Alpert Medical SchoolProvidenceUSA

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