Air insufflation for the treatment of intussusception in the Radiology Department at the University Hospital of the West Indies (UHWI) between 1998 and 2003

Abstract

Objectives: Intussusception, a common cause of an acute abdomen in children less than 2 years old can lead to bowel ischaemia with associated gangrene in undiagnosed cases with potentially fatal consequences. Air insufflation fluoroscopy is the method most commonly utilized at the Radiology Department of the University Hospital of the West Indies (UHWI) for both diagnosis and treatment of this condition. Internationally accepted rates of reduction are in excess of 70%, and perforation rates 3% or less. The reduction and perforation rates at the UHWI were previously undocumented.We aim to compare the reduction and perforation rates by air insufflation at the UHWI with the current standards in the literature. We also aim to identify potential causes of differences in rates and possible solutions for improving reduction rates. We also plan to propose a protocol to be instituted for all patients presenting for investigation and management of intussusception at UHWI.Method: A retrospective review of all cases performed between 1998 and 2003 was done using the logbooks available in the x-ray department.Results: There were 91 cases of suspected intussusception, Ages ranged from 6 weeks to 16 months. 51 cases were confirmed. The reduction rate was 56%. The perforation rate was 3.3%, not statistically significant from reports in the literature.Conclusions: Our reduction rate was found to be below the internationally accepted standard. This was thought to be due to lack of standard equipment and level of operator experience.