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© 2006 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 25:1125-1130 • 0278-4297

Intermittent Sonographic Guidance in Air Enemas for Reduction of Childhood Intussusception

Jong Hwa Lee, MD, Seong Hoon Choi, MD, Yoong Ki Jeong, MD, Woon Jung Kwon, MD, Ae Kyoung Jeong, MD, Byeong Seong Kang, MD and Shang Hun Shin, MD

Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

Address correspondence to Jong Hwa Lee, MD, Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine, 290-3 Cheonha-Dong, Dong-Ku, Ulsan 682-714, Korea. E-mail: jhlee{at}uuh.ulsan.kr

Objective. The purpose of this study was to prospectively assess the value of intermittent sonographic guidance in nonsurgical air reduction of childhood intussusception. Methods. The study group included 86 consecutive childhood intussusceptions confirmed on sonography for which we designed an air enema. With intermittent sonographic guidance of our own method, air was gradually injected to the initial intracolonic pressure of 60 mm Hg, which we attempted for 30 seconds on the initial attempt. If the air enema reduction attempts were not successful at a given pressure setting, we repeated the technique at each pressure setting upgraded by increments of 20 mm Hg up to 120 mm Hg. Surgery was performed when even repeated reduction attempts at the maximum intracolonic pressure of 120 mm Hg were unsuccessful. We calculated the successful reduction rate for the intussusceptions at each pressure setting. Results. The overall success rate of sonographically guided air enema reductions was 95% (82/86). The success rates of air enema reductions at 60, 80, 100, and 120 mm Hg showed progressive increases of 53% (42/86), 67% (58/86), 78% (67/86), and 95% (82/86), respectively, with no immediate recurrence and no gross perforation. Conclusions. The use of intermittent sonographic guidance in air enemas is thought to help safely increase successful reductions of childhood intussusception even with sufficient air enema attempts.

Key Words: gastrointestinal tract • intussusception • sonography

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Copyright © 2006 by the American Institute of Ultrasound in Medicine.