An audit of paediatric intussusception radiological reduction at the Bloemfontein Academic Hospital Complex, Free State, South Africa
Background. Intussusception remains the most common cause of bowel obstruction in infants and toddlers and can result in considerable morbidity and mortality if not properly treated. The aim of this study was to determine the success rate of air intussesception reduction (AIR), and to identify facto...
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| Veröffentlicht in: | SAJCH : the South African journal of child health 2013-05, Vol.7 (2), p.60-64 |
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| creator | Venter, J.A le Grange, S.M Otto, S.F Joubert, G |
| description | Background. Intussusception remains the most common cause of bowel obstruction in infants and toddlers and can result in considerable morbidity and mortality if not properly treated. The aim of this study was to determine the success rate of air intussesception reduction (AIR), and to identify factors predicting an unsuccessful procedure, among paediatric patients diagnosed with idiopathic intussusception at the Bloemfontein Academic Hospital Complex, Free State, South Africa. Methods. This retrospective analytic cohort study assessed data from the records of all paediatric patients with the diagnosis of idiopathic intussusception discharged from the Department of Paediatric Surgery between 1 January 2003 and 30 September 2011. Results. Thirty-five children with intussusception were identified. AIR enemas were performed in 18 children (51.4%), with successful reduction in 2 (11.1%). Seventeen children (48.6%) were primarily treated surgically without attempting radiological reduction. Successful AIR was more likely if the duration of symptoms was |
| doi_str_mv | 10.7196/SAJCH.531 |
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Intussusception remains the most common cause of bowel obstruction in infants and toddlers and can result in considerable morbidity and mortality if not properly treated. The aim of this study was to determine the success rate of air intussesception reduction (AIR), and to identify factors predicting an unsuccessful procedure, among paediatric patients diagnosed with idiopathic intussusception at the Bloemfontein Academic Hospital Complex, Free State, South Africa. Methods. This retrospective analytic cohort study assessed data from the records of all paediatric patients with the diagnosis of idiopathic intussusception discharged from the Department of Paediatric Surgery between 1 January 2003 and 30 September 2011. Results. Thirty-five children with intussusception were identified. AIR enemas were performed in 18 children (51.4%), with successful reduction in 2 (11.1%). Seventeen children (48.6%) were primarily treated surgically without attempting radiological reduction. Successful AIR was more likely if the duration of symptoms was <48 hours. Sixteen patients in whom AIR was attempted eventually required surgical intervention, either due to perforation during AIR or irreducibility. Approximately 94% of children required bowel resection at surgery. In 37.5% of cases AIR was complicated by perforation, making surgical treatment mandatory. Nine patients (56.3%) had unsuccessful AIR without perforation, but needed bowel resection at surgery. One patient (6.3 %) required manual reduction only, without the need for bowel resection at surgery. No deaths were recorded during the period covered by this audit. Conclusions. Our institution's radiological reduction outcomes were not comparable to international standards. The only statistically significant predictor of poor outcome of AIR was time delay before attempted reduction. S Afr J CH 2013;7(2):60-64. DOI:10.7196/SAJCH.531</description><identifier>ISSN: 1994-3032</identifier><identifier>ISSN: 1999-7671</identifier><identifier>EISSN: 1999-7671</identifier><identifier>DOI: 10.7196/SAJCH.531</identifier><language>eng</language><publisher>Health & Medical Publishing Group</publisher><subject>Care and treatment ; Children ; Demographic aspects ; Diagnosis ; Diseases ; Health Care Sciences & Services ; Intestines ; Intussusception ; Intussusception in children ; Patient outcomes ; Radiology ; Radiology, Medical</subject><ispartof>SAJCH : the South African journal of child health, 2013-05, Vol.7 (2), p.60-64</ispartof><rights>COPYRIGHT 2013 Health & Medical Publishing Group</rights><rights>This work is licensed under a Creative Commons Attribution 3.0 International License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-5be297e8b0d4a238b439d5190cd8772fd344b08e4b6292710c9dcd2fc19b25a63</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,864,885,27924,27925</link.rule.ids></links><search><creatorcontrib>Venter, J.A</creatorcontrib><creatorcontrib>le Grange, S.M</creatorcontrib><creatorcontrib>Otto, S.F</creatorcontrib><creatorcontrib>Joubert, G</creatorcontrib><title>An audit of paediatric intussusception radiological reduction at the Bloemfontein Academic Hospital Complex, Free State, South Africa</title><title>SAJCH : the South African journal of child health</title><addtitle>S. Afr. j. child health</addtitle><description>Background. Intussusception remains the most common cause of bowel obstruction in infants and toddlers and can result in considerable morbidity and mortality if not properly treated. The aim of this study was to determine the success rate of air intussesception reduction (AIR), and to identify factors predicting an unsuccessful procedure, among paediatric patients diagnosed with idiopathic intussusception at the Bloemfontein Academic Hospital Complex, Free State, South Africa. Methods. This retrospective analytic cohort study assessed data from the records of all paediatric patients with the diagnosis of idiopathic intussusception discharged from the Department of Paediatric Surgery between 1 January 2003 and 30 September 2011. Results. Thirty-five children with intussusception were identified. AIR enemas were performed in 18 children (51.4%), with successful reduction in 2 (11.1%). Seventeen children (48.6%) were primarily treated surgically without attempting radiological reduction. Successful AIR was more likely if the duration of symptoms was <48 hours. Sixteen patients in whom AIR was attempted eventually required surgical intervention, either due to perforation during AIR or irreducibility. Approximately 94% of children required bowel resection at surgery. In 37.5% of cases AIR was complicated by perforation, making surgical treatment mandatory. Nine patients (56.3%) had unsuccessful AIR without perforation, but needed bowel resection at surgery. One patient (6.3 %) required manual reduction only, without the need for bowel resection at surgery. No deaths were recorded during the period covered by this audit. Conclusions. Our institution's radiological reduction outcomes were not comparable to international standards. The only statistically significant predictor of poor outcome of AIR was time delay before attempted reduction. S Afr J CH 2013;7(2):60-64. DOI:10.7196/SAJCH.531</description><subject>Care and treatment</subject><subject>Children</subject><subject>Demographic aspects</subject><subject>Diagnosis</subject><subject>Diseases</subject><subject>Health Care Sciences & Services</subject><subject>Intestines</subject><subject>Intussusception</subject><subject>Intussusception in children</subject><subject>Patient outcomes</subject><subject>Radiology</subject><subject>Radiology, Medical</subject><issn>1994-3032</issn><issn>1999-7671</issn><issn>1999-7671</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>KPI</sourceid><recordid>eNptkt2K1EAQhYMouK5e-AYNgiBsxv6bJH0ZB9dZXVAYvW4q3ZVJD0k6dHdg9wF8b5PdBR3woqiiOOcUfFSWvWV0UzJVfDzUX3f7zVawZ9kFU0rlZVGy5w-zzAUV_GX2KsYTpQWVVXWR_a5HArN1ifiWTIDWQQrOEDemOcY5GpyS8yMJYJ3v_dEZ6ElAO5uHNSSSOiSfeo9D68eEbiS1AYvDkrH3cXJp0e_8MPV4d0WuAyI5JEh4RQ5-Th2p2-UavM5etNBHfPPUL7Nf159_7vb57fcvN7v6NjeS0pRvG-SqxKqhVgIXVSOFslumqLFVWfLWCikbWqFsCq54yahR1ljeGqYavoVCXGabx9xoHPZen_wcxuWgPqys9MqKUyYopXwpuhrePRqO0KN2Y-tTADO4aHQthCglL5T8G3umgicOfsTWLfszw4czg1nR3aUjLMz1tx8359r3_2g7hD510ffzyj_-N9QEH2PAVk_BDRDuNaN6fQ4d4WQ6vTyH-AMz_6kT</recordid><startdate>20130501</startdate><enddate>20130501</enddate><creator>Venter, J.A</creator><creator>le Grange, S.M</creator><creator>Otto, S.F</creator><creator>Joubert, G</creator><general>Health & Medical Publishing Group</general><scope>AAYXX</scope><scope>CITATION</scope><scope>KPI</scope><scope>GPN</scope></search><sort><creationdate>20130501</creationdate><title>An audit of paediatric intussusception radiological reduction at the Bloemfontein Academic Hospital Complex, Free State, South Africa</title><author>Venter, J.A ; le Grange, S.M ; Otto, S.F ; Joubert, G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-5be297e8b0d4a238b439d5190cd8772fd344b08e4b6292710c9dcd2fc19b25a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Care and treatment</topic><topic>Children</topic><topic>Demographic aspects</topic><topic>Diagnosis</topic><topic>Diseases</topic><topic>Health Care Sciences & Services</topic><topic>Intestines</topic><topic>Intussusception</topic><topic>Intussusception in children</topic><topic>Patient outcomes</topic><topic>Radiology</topic><topic>Radiology, Medical</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Venter, J.A</creatorcontrib><creatorcontrib>le Grange, S.M</creatorcontrib><creatorcontrib>Otto, S.F</creatorcontrib><creatorcontrib>Joubert, G</creatorcontrib><collection>CrossRef</collection><collection>Global Issues</collection><collection>SciELO</collection><jtitle>SAJCH : the South African journal of child health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Venter, J.A</au><au>le Grange, S.M</au><au>Otto, S.F</au><au>Joubert, G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An audit of paediatric intussusception radiological reduction at the Bloemfontein Academic Hospital Complex, Free State, South Africa</atitle><jtitle>SAJCH : the South African journal of child health</jtitle><addtitle>S. Afr. j. child health</addtitle><date>2013-05-01</date><risdate>2013</risdate><volume>7</volume><issue>2</issue><spage>60</spage><epage>64</epage><pages>60-64</pages><issn>1994-3032</issn><issn>1999-7671</issn><eissn>1999-7671</eissn><abstract>Background. Intussusception remains the most common cause of bowel obstruction in infants and toddlers and can result in considerable morbidity and mortality if not properly treated. The aim of this study was to determine the success rate of air intussesception reduction (AIR), and to identify factors predicting an unsuccessful procedure, among paediatric patients diagnosed with idiopathic intussusception at the Bloemfontein Academic Hospital Complex, Free State, South Africa. Methods. This retrospective analytic cohort study assessed data from the records of all paediatric patients with the diagnosis of idiopathic intussusception discharged from the Department of Paediatric Surgery between 1 January 2003 and 30 September 2011. Results. Thirty-five children with intussusception were identified. AIR enemas were performed in 18 children (51.4%), with successful reduction in 2 (11.1%). Seventeen children (48.6%) were primarily treated surgically without attempting radiological reduction. Successful AIR was more likely if the duration of symptoms was <48 hours. Sixteen patients in whom AIR was attempted eventually required surgical intervention, either due to perforation during AIR or irreducibility. Approximately 94% of children required bowel resection at surgery. In 37.5% of cases AIR was complicated by perforation, making surgical treatment mandatory. Nine patients (56.3%) had unsuccessful AIR without perforation, but needed bowel resection at surgery. One patient (6.3 %) required manual reduction only, without the need for bowel resection at surgery. No deaths were recorded during the period covered by this audit. Conclusions. Our institution's radiological reduction outcomes were not comparable to international standards. The only statistically significant predictor of poor outcome of AIR was time delay before attempted reduction. S Afr J CH 2013;7(2):60-64. DOI:10.7196/SAJCH.531</abstract><pub>Health & Medical Publishing Group</pub><doi>10.7196/SAJCH.531</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1994-3032 |
| ispartof | SAJCH : the South African journal of child health, 2013-05, Vol.7 (2), p.60-64 |
| issn | 1994-3032 1999-7671 1999-7671 |
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| source | African Journals Online (Open Access); DOAJ Directory of Open Access Journals; Sabinet African Journals Open Access Collection; Alma/SFX Local Collection; EZB Electronic Journals Library |
| subjects | Care and treatment Children Demographic aspects Diagnosis Diseases Health Care Sciences & Services Intestines Intussusception Intussusception in children Patient outcomes Radiology Radiology, Medical |
| title | An audit of paediatric intussusception radiological reduction at the Bloemfontein Academic Hospital Complex, Free State, South Africa |
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