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Comparison of Diagnostic and Therapeutic Efficacy between Ultrasound Guided Hydrostatic Saline Reduction and Fluoroscopic Barium Reduction in Children with Intussusception

Journal of the Korean Pediatric Society 1995;38(12):1664-1670.
Published online December 15, 1995.
Comparison of Diagnostic and Therapeutic Efficacy between Ultrasound Guided Hydrostatic Saline Reduction and Fluoroscopic Barium Reduction in Children with Intussusception
Chi Hyung Park1, Ho Seok Lee1, Chong Woo Bae1, Sa Jun Chung1, Young Mook Choi1, Sun Wha Lee1, Yup Yun2
1Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Korea
2Department of Diagnostic Radiology, Kyung Hee University College of Medicine, Seoul, Korea
소아 장중첩중의 치료에 었어서 초음파 유도하 식염수 청복술과 x-선투시 바려움 관장법에 의한 정복술의 벼교 관찰
박치형1, 이호석1, 배종우1, 정사준1, 최용묵1, 이선화1, 윤엽2
1경회대학교 의과대학 소아과학교실
2경회대학교 의과대학 진단방사선과학교실
Abstract
Purpose
: Several studies recently have emphasized the value of sonography as an new therapeutic method for hydrostatic reduction of intussusception by using a saline enema under ultrasound guidance. The purpose of this study was to asses the diagnostic screening efficacy of sonography in suspected childhood intussusception and the value of ultrasound guidance in hydrostatic reduction performed with saline enema.
Methods
: We have conducted the clinical observation in 72 patients with intussusception who were treated by hydrostatic saline reduction under the ultrasono¡ⓒ graphic guidance in Kyung-Hee University Hospital from January 1991 to December 1993. We have observed the ultrasonographic findings in intussusception and compared the reduction rate with that of 166 cases of control group who were treated by conventional barium enema method for same duration.
Results
: 1) The reduction rate by hydrostatic saline reduction under ultrasound guidance was 79.2% and that of barium enema was 71.7%. But there was no statistically significant difference of reduction rate according to the type of reduction (p>O.05). 2) The reduction rate of hydrostatic saline reduction and barium reduction in the patients who visited within 24hours from the onset of symptoms(91.3% and 87.0%, respectevely) was higher than that of those who visited after 24 hours(57.7% and 43.1%, respectively)(p<0.OO5). But there was no significant difference of reduction rate between that were done within 24 hours and after 24 hours in both reduction types(p>O.05). 3) The reduction rate of hydrostatic saline reduction was higher in the group of ileocolic type(91.5%) than that of other types(30.8%)(p<0.OO5). In barium enema group, there was also higher in the group of ileocolic type (76.6%) than that of other types (61.8%) (p>O.05). 4) The recurrence rate of hydrostatic saline reduction was 5.6% and that of barium reduction was 7.8%. 5) There was no complications during and after the procedure.
Conclusion
: We observed advantages of ultrasound guided hydrostatic saline reduction compared with barium enema such as higher reduction rate, no radiologic hazards, and abscence of life-threatening complications. It is our opinion that ultrasound guided hydrostatic saline reduction is the safe and reliable method for treatment of intussusception in infants and childhood and ultrasound guided saline reduction can replace instead of barium reduction.
Key Words: Intussusception, Ultrasonogram, Hydrostatic saline reduction, Barium reduction


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