At Keimyung University Dongsan Medical Center, the hydrostatic waster enema under ultrasound guidance has been used for diagnosis and treatment of intussusception in childhood and gradually substituted the barium enema.
The purpose o this study was to evaluate the reduction rate and factors influencing reducibility by reduction methods from 325 consecutive patients with intussusception, 245 patients treated with barium enema(BE group) and 80 patients treated
with
water
enema under ultrasound guidance (US group) from April 1988 to March 1991.
There were similar with regard to sex distribution, age, body weight, duration of symptom, signs, body temperature and WBC count in groups. Successful reduction was achieved in 77.6% of patients treated with barium enema and 83.8% of patients
treated
with water enema.
In BE group, there was statistical significance of successful reduction in patient with body temperature less than 38.5℃(p<0.01) or greater body weight(p<0.01), but less success in patients passed bloody stool spontaneously(p<0.05).
In US group, duration of symptoms was a definitive factor in reducibility(p<0.05).
There was statistically significant difference of success rate of reduction between US group(9j4.1%) and BE group(82.0%) of the patients with symptoms for 24 hours or less but there was no difference of reduction rate (62.3% vs 69.7%) with
symptoms
for
greater than 24 hours by reduction methods.
The incidence of recurrence was similar with 5.3% in BE group and 7.5% in US group and there was no perforation during attempted reduction with barium or water.
We feel hydrostatic water enema under ultrasound guidance is safe and believe it is one of most promising method in the diagnosis and treatment of intussusception.
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