Intussusception surgery: Difference between revisions
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==Surgery== | ==Surgery== | ||
* '''Indications''' of surgical intervention include : | |||
** Unstable patient | |||
** Stable patient : when non operative reduction is completely unsuccessful. | |||
** Intestinal perforation | |||
** Peritonitis | |||
** A mass lesion - Imaging shows a persistent focal filling defect.<ref name="pmid8308683">{{cite journal |vauthors=Pierro A, Donnell SC, Paraskevopoulou C, Carty H, Lloyd DA |title=Indications for laparotomy after hydrostatic reduction for intussusception |journal=J. Pediatr. Surg. |volume=28 |issue=9 |pages=1154–7 |year=1993 |pmid=8308683 |doi= |url=}}</ref> | |||
* '''Technique''' | |||
** I.V. fluid resuscitation | |||
** Prophylactic antibiotics covering enteric flora | |||
** Nasogastric tube decompression if the patient has nausea and emesis. | |||
** Pediatric surgeons prefer minimally invasive approach through laproscope. | |||
** Benefits of laproscopy are:- <ref name="pmid17685958">{{cite journal |vauthors=Cheung ST, Lee KH, Yeung TH, Tse CY, Tam YH, Chan KW, Yeung CK |title=Minimally invasive approach in the management of childhood intussusception |journal=ANZ J Surg |volume=77 |issue=9 |pages=778–81 |year=2007 |pmid=17685958 |doi=10.1111/j.1445-2197.2007.04228.x |url=}}</ref> | |||
*** Laproscopic approach allows accurate diagnosis and reduction of intussusception. | |||
*** Rapid recovery | |||
*** Minimal use of narcotic analgesia post-operatively. | |||
** Reduction is successful | |||
Reduction of intussusception during operation is attempted in most cases, but resection with primary anastomosis is performed if manual reduction is not possible or if a pathological lead point is seen. The risk of recurrence is approximately 1 percent after manual reduction and virtually nonexistent after surgical resection [121]. | |||
==References== | ==References== | ||
Revision as of 18:37, 28 December 2017
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Intussusception On the Web |
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American Roentgen Ray Society Images of Intussusception |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Surgery
- Indications of surgical intervention include :
- Unstable patient
- Stable patient : when non operative reduction is completely unsuccessful.
- Intestinal perforation
- Peritonitis
- A mass lesion - Imaging shows a persistent focal filling defect.[1]
- Technique
- I.V. fluid resuscitation
- Prophylactic antibiotics covering enteric flora
- Nasogastric tube decompression if the patient has nausea and emesis.
- Pediatric surgeons prefer minimally invasive approach through laproscope.
- Benefits of laproscopy are:- [2]
- Laproscopic approach allows accurate diagnosis and reduction of intussusception.
- Rapid recovery
- Minimal use of narcotic analgesia post-operatively.
- Reduction is successful
Reduction of intussusception during operation is attempted in most cases, but resection with primary anastomosis is performed if manual reduction is not possible or if a pathological lead point is seen. The risk of recurrence is approximately 1 percent after manual reduction and virtually nonexistent after surgical resection [121].
References
- ↑ Pierro A, Donnell SC, Paraskevopoulou C, Carty H, Lloyd DA (1993). "Indications for laparotomy after hydrostatic reduction for intussusception". J. Pediatr. Surg. 28 (9): 1154–7. PMID 8308683.
- ↑ Cheung ST, Lee KH, Yeung TH, Tse CY, Tam YH, Chan KW, Yeung CK (2007). "Minimally invasive approach in the management of childhood intussusception". ANZ J Surg. 77 (9): 778–81. doi:10.1111/j.1445-2197.2007.04228.x. PMID 17685958.