Current Trends in the Treatment of Invagination in Childhood
Authors:
R. Štichhauer 1; J. Koudelka 1; P. Rejtar 2
Authors‘ workplace:
Oddělení dětské chirurgie a traumatologie, Fakultní nemocnice Hradec Králové
primář MUDr. J. Koudelka, CSc.
1; Radiologická klinika, Fakultní nemocnice Hradec Králové
přednosta prof. MUDr. P. Eliáš, CSc.
2
Published in:
Čes-slov Pediat 2010; 65 (11): 634-638.
Category:
Original Papers
Overview
Aim:
Evaluation of outcomes in patients diagnosed with invagination over an eight-year period with a focus on hydrostatic disinvagination performed under general anesthesia.
Material and methods:
In 2000–2008, 86 children diagnosed with invagination were treated at the Department of Pediatric Surgery and Traumatology in Hradec Králové. Retrospective medical record data were used to analyze in particular diagnostic and therapeutic protocol, treatment outcome and recurrence (if any) with a focus on hydrostatic disinvagination performed under general anesthesia.
Results:
Most (74.4%) of the 86 study patients were males. The majority of cases were diagnosed in infants and toddlers. Predominant symptoms were restlessness and abdominal pain, observed in 99% of cases. Enterorrhagia was reported in 45.3% of patients. Invagination was most often located in the ileocolic area. The diagnostic method of choice was ultrasonography, followed by hydrostatic disinvagination, when needed, performed under X-ray or ultrasonography guidance. The successful outcome rate was close to 77%.
The successful outcome rates of hydrostatic disinvagination were 78.8% when performed under general anesthesia and 81.1% when performed without general anesthesia. The most frequent surgical procedures were disinvagination and appendectomy. Recurrence was reported in 9.3% of patients. Hydrostatic disinvagination in patients with recurrence led to successful outcomes in 71% of cases. No death was recorded.
Discussion and conclusion:
Based on our data, general anesthesia does not increase the successful outcome rate of hydrostatic disinvagination. Nevertheless, it provides evident benefits in terms of procedure safety and comfort for the patient and surgical team.
Key words:
invagination, sonography, hydrostatic disinvagination, surgery, anesthesia, recurrence
Sources
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Labels
Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2010 Issue 11
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