Intussusception surgery
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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.