Ultrasound-guided Hartmann's solution enema: first-choice procedure for reducing idiopathic intussusception

Radiol Med. 2012 Jun;117(4):679-89. doi: 10.1007/s11547-011-0769-3. Epub 2012 Jan 7.

Abstract

Purpose: This study was undertaken to compare the effectiveness of ultrasound-guided Hartmann's solution enema (US-E) and radiological liquid enema (RX-E) in reducing idiopathic ileocecocolic intussusceptions in relation to patient age and symptom duration.

Materials and methods: The study group consisted of 42 patients with idiopathic ileocecocolic intussusception treated with US-E (20 patients) or RX-E (23 patients), with one patient undergoing both procedures owing to recurrence. Patients were divided into subgroups according to age (<6 months, 6-12 months, >12 months) and symptom duration (<12 h, 12-24 h, >24 h).

Results: Complete reduction was achieved in 15/20 patients treated with US-E (75%) and in 10/23 treated with RX-E (43.5%) (p=ns). Recurrence was observed in 1/20 US-E and 0/23 RX-E (p=ns) patients. No complications were encountered. US-E had a significantly higher success rate than RX-E in patients >12 months (p=0.0063) and with symptom duration >24 h (p=0.0361). No differences were found in the other subgroups (p=ns).

Conclusions: US-E and RX-E are procedures of comparable value and safety in reducing idiopathic intussusception. US-E seems to be more effective in patients >12 months or with symptom duration >24 h. As US-E avoids radiation exposure, it should be considered the first-choice procedure for reducing idiopathic ileocecocolic intussusception, particularly in these two subgroups of patients.

Publication types

  • Comparative Study

MeSH terms

  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Contrast Media / administration & dosage
  • Diatrizoate Meglumine / administration & dosage
  • Enema / adverse effects
  • Enema / methods*
  • Female
  • Humans
  • Hydrostatic Pressure
  • Ileal Diseases / diagnostic imaging
  • Ileal Diseases / therapy*
  • Infant
  • Intussusception / diagnostic imaging
  • Intussusception / therapy*
  • Isotonic Solutions / therapeutic use*
  • Male
  • Radiography, Interventional
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome
  • Ultrasonography, Interventional*

Substances

  • Contrast Media
  • Isotonic Solutions
  • Diatrizoate Meglumine