Significance of Follow-Up Ultrasonography 24 Hours Post-Reduction in Detecting Intussusception Recurrence
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Purpose: The objective of this study was to identify the significance of 24-hour post-reduction ultrasonography (US) in pediatric patients with intussusception. Methods: A total of 229 patients with intussusception who were treated with saline reduction at Severance Children’s Hospital between January 2014 and September 2020 were retrospectively reviewed. The 229 patients with successful saline reduction were divided into two groups: a recurrence at 24 hours group (R, n=41) and a non-recurrence group (NR, n=188). The full patient sample was divided into two groups: follow-up US (FU) or no follow-up US (NFU); the recurrence group was divided into follow-up (R-FU) and non-follow-up (R-NFU) subgroups, and stratified analyses were performed. Results: There were no significant differences in age, sex, laboratory findings, symptoms, and sonographic findings between the NR and R groups. In the R group, 24 patients underwent follow-up US, and 17 patients did not. Specific sonographic findings were statistically significant in the R-FU group compared to the R-NFU group (p=0.002). The R-FU group had fewer admissions (p=0.012) and longer mean hospitalization times (p<0.001) than the R-NFU group. The NFU group had a 12.2% recurrence rate, while the R-FU group recurrence rate was 25.8% (p=0.0099), suggesting that the omission of some recurrent events and follow-up US was a significant variable in the recurrence of intussusception. The median time to recurrence was 21 hours which supports the 24-hour follow-up protocol. Conclusion: Twenty-four-hour follow-up US was shown to be valuable for detecting early recurrence of intussusception.
Abstract
Purpose: The objective of this study was to identify the significance of 24-hour post-reduction ultrasonography (US) in pediatric patients with intussusception. Methods: A total of 229 patients with intussusception who were treated with saline reduction at Severance Children’s Hospital between January 2014 and September 2020 were retrospectively reviewed. The 229 patients with successful saline reduction were divided into two groups: a recurrence at 24 hours group (R, n=41) and a non-recurrence group (NR, n=188). The full patient sample was divided into two groups: follow-up US (FU) or no follow-up US (NFU); the recurrence group was divided into follow-up (R-FU) and non-follow-up (R-NFU) subgroups, and stratified analyses were performed. Results: There were no significant differences in age, sex, laboratory findings, symptoms, and sonographic findings between the NR and R groups. In the R group, 24 patients underwent follow-up US, and 17 patients did not. Specific sonographic findings were statistically significant in the R-FU group compared to the R-NFU group (p=0.002). The R-FU group had fewer admissions (p=0.012) and longer mean hospitalization times (p<0.001) than the R-NFU group. The NFU group had a 12.2% recurrence rate, while the R-FU group recurrence rate was 25.8% (p=0.0099), suggesting that the omission of some recurrent events and follow-up US was a significant variable in the recurrence of intussusception. The median time to recurrence was 21 hours which supports the 24-hour follow-up protocol. Conclusion: Twenty-four-hour follow-up US was shown to be valuable for detecting early recurrence of intussusception.
참고문헌 (23)
- Bruce J, "Intussusception : evolution of current management", J Pediatr Gastroenterol Nutr, 6, pp.663~674 (1987)
- Eun Hye Lee, "Nationwide Population-Based Epidemiologic Study on Childhood Intussusception in South Korea: Emphasis on Treatment and Outcomes", Pediatric Gastroenterology, Hepatology & Nutrition, 23(4), pp.329~345 (2020), 대한소아소화기영양학회[DOI]
- Tate JE, "Trends in intussusception hospitalizations among US infants, 1993-2004 : implications for monitoring the safety of the new rotavirus vaccination program", Pediatrics, 121, pp.e1125~32 (2008)
- Lioubashevsky N, "Ileocolic versus small-bowel intussusception in children : can US enable reliable differentiation?", Radiology, 269, pp.266~271 (2013)
- Beres AL, "An institutional analysis and systematic review with meta-analysis of pneumatic versus hydrostatic reduction for pediatric intussusception", Surgery, 154, pp.328~334 (2013)
- Otero HJ, "Imaging intussusception in children’s hospitals in the United States : trends, outcomes, and costs", J Am Coll Radiol, 16, pp.1636~1644 (2019)
- Gray MP, "Recurrence rates after intussusception enema reduction : a meta-analysis", Pediatrics, 134, pp.110~119 (2014)
- Jae Young Choe, "Identifying Predictive Factors for the Recurrence of Pediatric Intussusception", Pediatric Gastroenterology, Hepatology & Nutrition, 22(2), pp.142~151 (2019), 대한소아소화기영양학회[DOI]
- Daneman A, "Part 2 : an update on the evolution of management", Pediatr Radiol, 34, pp.97~108 (2004)
- Litz CN, "Outpatient management of intussusception : a systematic review and meta-analysis", J Pediatr Surg, 54, pp.1316~1323 (2019)
- Bajaj L, "Postreduction management of intussusception in a children’s hospital emergency department", Pediatrics, 12(6), pp.1302~1307 (2003)
- Herwig K, "Enema-reduced intussusception management : is hospitalization necessary?", Pediatr Emerg Care, 25, pp.74~77 (2009)
- Al-Jazaeri A, "Utility of hospital admission after successful enema reduction of ileocolic intussusception", J Pediatr Surg, 41, pp.1010~1013 (2006)
- Mallicote MU, "Discussion of : "hospital admission unnecessary for successful uncomplicated radiographic reduction of pediatric intussusception"", Am J Surg, 214, pp.1208~1209 (2017)
- Amuddhu SK, "Inpatient admission versus emergency department management of intussusception in children : a systemic review and meta-analysis of outcomes", Eur J Pediatr Surg, 29, pp.7~13 (2019)
- Gilmore AW, "Management of childhood intussusception after reduction by enema", Am J Emerg Med, 29, pp.1136~1140 (2011)
- Eklöf O, "Recurrent intussusception. Analysis of a series treated with hydrostatic reduction", Acta Radiol Diagn (Stockh), 19(1), pp.250~258 (1978)
- Kwon H, "A practice guideline for postreduction management of intussusception of children in the emergency department", Pediatr Emerg Care, 35, pp.533~538 (2019)
- Cho MJ, "Management of recurrent ileocolic intussusception", J Pediatr Surg, 55, pp.2150~2153 (2020)
- Xie X, "Risk factors for recurrence of intussusception in pediatric patients : a retrospective study", J Pediatr Surg, 53, pp.2307~2311 (2018)
- Guo WL, "Risk factors for recurrent intussusception in children : a retrospective cohort study", BMJ Open, 7, pp.e018604~ (2017)
- Espinoza Vega ML, "Recurrence of uncomplicated intestinal intussusception. Can it be treated as an outpatient?", Cir Pediatr, 30, pp.95~99 (2017)
- Simanovsky N, "Early recurrence of ileocolic intussusception after successful air enema reduction : incidence and predisposing factors", Emerg Radiol, 26, pp.1~4 (2019)