Document Detail


Radiographic reduction of intussusception in patients with cystic fibrosis.
MedLine Citation:
PMID:  17594107     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Cystic fibrosis (CF) is a genetic disorder affecting approximately one in 2,500 births in the United States. Nearly 1% of patients with CF will develop intussusception, which is commonly ileocecal and felt to be secondary to inspissated feces. These patients generally present before the age of ten. Once the diagnosis of intussusception is confirmed on ultrasound or CT, surgery has been the mainstay of treatment in this patient group. We propose the use of air and contrast enemas as effective and beneficial non-operative approach in these patients. Clinical and imaging findings in four children with known CF who presented with intestinal intussusception, average age 13.25 +/- 5.3 years (range 8-18 years) were reviewed. Patients were diagnosed using ultrasound (n = 3) or abdominal CT (n = 1). All patients suffered from an ileocolic intussusception. Air and Gastrografin(R) enemas were used in an attempt to reduce the intussusception. There were six separate successful intussusception reductions in four patients. Three patients required multiple attempts (2.3 +/- 0.6). Air enemas were used initially in all cases. Gastrografin(R) was used successfully following the failure of air enema in one patient. One patient suffered three separate intussusceptions over a period of 18 months, which were all successfully reduced using air. There were no complications and the patients tolerated the procedure well. Intussusception is an uncommon but serious complication in children with CF. While surgical reduction has been the mainstay of treatment for these patients, we demonstrated that reduction of an intussusception using air or contrast can be accomplished safely, without anesthesia, and should be the initial treatment option.
Authors:
Benjamin Pomerantz; Sudha Anupindi; Paul W Wales; Daniel P Doody; Peter T Masiakos
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Publication Detail:
Type:  Journal Article     Date:  2007-06-27
Journal Detail:
Title:  Pediatric surgery international     Volume:  23     ISSN:  0179-0358     ISO Abbreviation:  Pediatr. Surg. Int.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-20     Completed Date:  2007-10-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8609169     Medline TA:  Pediatr Surg Int     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  763-5     Citation Subset:  IM    
Affiliation:
Department of Radiology, Massachusetts General Hospital, Boston, MA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Air
Child
Contrast Media / therapeutic use*
Cystic Fibrosis / complications*
Diatrizoate Meglumine / therapeutic use*
Enema*
Humans
Intussusception / etiology,  radiography*,  therapy*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Contrast Media; 131-49-7/Diatrizoate Meglumine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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