Pneumatic Reduction Of Intussusception In Children At The Komfo Anokye Hospital, Kumasi, Ghana

Abstract

Objective: To evaluate the role of pneumatic reduction in the management of
intussusception in children in the setting of a sub-Saharan African nation.
Design: Prospective case series.
Setting: Tertiary care teaching hospital in Kumasi, Ghana.
Subjects: Forty four children, aged 4 months to 13 years, 28 boys and 16 girls, were admitted with a clinical diagnosis of intussusception and confirmed by ultrasonography.
Interventions: Twenty two children had air enema reduction of the intussusception
attempted in the operation theatre under general anaesthesia. The average pressure
used for air enema reduction of the intussusceptions was 110.4 mm Hg.
Main outcome measures: Success of pneumatic reduction, morbidity and mortality.
Results: Overall air enema reduction of intussusception was successful in 59.1% of
children who underwent this procedure. There were no deaths among children who
had a successful air enema reduction of intussusception. One child (11.1 %) out of nine
who had laparotomy done after a failed pneumatic reduction died. The average length
of hospital stay was shorter in those with successful air enema reduction (3.8 ± 2.3 days,
95% Confidence Interval [CI] = 2.4 to 5.2) than those who had a laparotomy performed
for manual reduction of the intussusception after a failed pneumatic reduction (6.7 ±
5.1 days, 95% CI = 33 to 9.9).
Conclusion: Although the sample size is small, pneumatic reduction of intussusception
in children without peritonitis is possible, practical, and reliable and must be tried
first, preferably under general anaesthesia in our sub-region before proceeding to
laparotomy in case of failure.

East African Medical Journal Vol. 85 (11) 2008: pp. 550-555