Intussusception surgery
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Intussusception Microchapters |
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Treatment |
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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]; AESargun Singh Walia M.B.B.S.[2]
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][3][4][5]
- Laproscopic approach allows accurate diagnosis and reduction of intussusception.
- Rapid recovery
- Minimal use of narcotic analgesia post-operatively.
- Reduction is successful in most cases.
- Primary anastomosis is done if manual reduction is not successful.
- Primary anastomosis is also done if there is a pathologic lead point.
- Recurrence can occurs is less than 1% cases.[6]
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.
- ↑ <ref name="pmid23327343">Hill SJ, Koontz CS, Langness SM, Wulkan ML (2013). "Laparoscopic versus open reduction of intussusception in children: experience over a decade". J Laparoendosc Adv Surg Tech A. 23 (2): 166–9. doi:10.1089/lap.2012.0174. PMID 23327343.
- ↑ Sklar CM, Chan E, Nasr A (2014). "Laparoscopic versus open reduction of intussusception in children: a retrospective review and meta-analysis". J Laparoendosc Adv Surg Tech A. 24 (7): 518–22. doi:10.1089/lap.2013.0415. PMID 24987845.
- ↑ Houben CH, Feng XN, Tang SH, Chan EK, Lee KH (2016). "What is the role of laparoscopic surgery in intussusception?". ANZ J Surg. 86 (6): 504–8. doi:10.1111/ans.13435. PMID 26699630.
- ↑ Madonna MB, Boswell WC, Arensman RM (1997). "Acute abdomen. Outcomes". Semin. Pediatr. Surg. 6 (2): 105–11. PMID 9159862.