MyMedR

Fulltext Intussusception as a complication of gastrostomy tube: a case report

Hussain M, Thambidorai CR

Med J Malaysia, 2000 Jun;55(2):271-2.

PMID: 19839160

A neurologically impaired child who had fundoplication and gastrostomy done for gastroesophageal at the age of three, presented two years later with intestinal obstruction. She underwent laparotomy and was found to have antegrade jejuno-jejunal intussusception. Intussusception is an unusual but recognised complication of gastrostomy tube placement.

Matched MeSH terms: Intussusception/therapy

Fulltext Barium enema reduction of intussusception in children

Goon Hong Kooi

Med J Malaysia, 1986 Jun;41(2):166-9.

PMID: 3821614

Barium enema hydrostatic reduction was carried out for eight patients with Intussusception over a six-month period. There were five successes (62%) and three failures. There were no mortality or complications arising out of this procedure. The technique is discussed. This procedure offers many advantages over surgical reduction. However, it is not a substitute for surgery which is still indicated in the sick infants and in those where hydrostatic reduction failed.

Matched MeSH terms: Intussusception/therapy*

Fulltext Adult intussusception: 5-year experience in Sarawak

Siow SL, Chea CH, Hashimah AR, Ting SC

Med J Malaysia, 2011 Aug;66(3):199-201.

PMID: 22111440 MyJurnal

Adult intussusception is rare. It represents only 5% of all intussusceptions and 1% of bowel obstruction. Clinical presentations are usually variable with a variety of acute, intermittent and chronic symptoms. It is associated with an underlying pathologic process in 90% of cases. A lack of Malaysia data prompted review of the Sarawak experience with this uncommon entity, focusing on the clinical features, diagnostic procedure and treatment. During the last 5 years, there were 14 cases of surgically proven adult intussusception. Mean age was 45.9 years. There were 9 enteric and 5 colonic intussusceptions. Ninety-three percent of the intussusceptions were associated with a pathologic lesion. Thirty-three percent of the enteric lesions were malignant and 67% were benign. Eighty percent of the colonic lesions were malignant and 20% were benign. Computed tomography scan has a good diagnostic accuracy of 83% and should be considered for all patients with nonspecific abdominal symptoms or suspected bowel obstruction. Treatment of choice for colonic intussusception in adults is en bloc resection without reduction whenever possible, whereas a more selective approach for enteric lesions.

Matched MeSH terms: Intussusception/therapy*

Fulltext Pneumatic reduction of intussusception using equipment readily available in the hospital

Zulfiqar MA, Noryati M, Hamzaini AH, Thambidorai CR

Med J Malaysia, 2006 Jun;61(2):199-203.

PMID: 16898311 MyJurnal

The purpose of this study was to determine the effectiveness of pneumatic reduction of intussusception using equipment readily available in the hospital. Twenty-two children aged between four months and four years had pneumatic reduction of intussusception. The device used was assembled using (i) a hand-held pump attached to a pressure gauge, and (ii) a 3-way Foley's balloon catheter. There was a 73% success rate and there were no complications. The device used was effective and safe for the pneumatic reduction of intussusception.

Matched MeSH terms: Intussusception/therapy*

Factors associated with ultrasound-guided water enema reduction for pediatric intussusception in resource-limited setting: potential predictive role of thrombocytosis and anemia

Lim RZM, Lee T, Ng JYZ, Quek KF, Abdul Wahab N, Amansah SL, et al.

J Pediatr Surg, 2018 Nov;53(11):2312-2317.

PMID: 29459045 DOI: 10.1016/j.jpedsurg.2018.01.004

BACKGROUND/PURPOSE: Although ultrasound-guided hydrostatic reduction (USGHR) is increasingly used in managing pediatric intussusception, there is limited literature concerning its use in Malaysia. We aim to examine the experience and factors associated with the effectiveness of USGHR using water.

METHODS: This is a single-center retrospective observational study in a Malaysian tertiary referral center. Children with intussusception admitted between year 2012 and 2016 were included and medical records reviewed. Factors associated with success or failure of USGHR were identified using multivariable logistic regression.

RESULTS: Of the 172 cases included, 151 cases (87.8%) underwent USGHR, of whom 129 cases were successfully reduced (success rate of 85.4%). One perforation (0.7%) was reported. Age more than 3years old (aOR=7.16; 95% CI=1.07-47.94; p=0.042), anemia (aOR=10.12; 95% CI=1.12-91.35; p=0.039), thrombocytosis (aOR=11.21; 95% CI=2.06-64.33; p=0.005) and ultrasound findings of free fluid (aOR=9.39; 95% CI=1.62-54.38; p=0.012) and left-sided intussusception (aOR=8.18;95% CI=1.22-54.90, p=0.031) were independently associated with USGHR irreducibility. Symptom duration, blood in stool, vomiting and other clinical presentations, however, showed no association.

CONCLUSIONS: USGHR with water is effective in the non-operative management of pediatric intussusception. Prolonged symptom duration need not necessarily preclude USGHR. The findings of anemia and thrombocytosis as independent predictors of USGHR irreducibility deserve further study.

TYPE OF STUDY: Treatment study LEVEL OF EVIDENCE: III.

Matched MeSH terms: Intussusception/therapy*

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