Intussusception Reduction

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Intussusception in Children: Current Concepts in Diagnosis and Enema Reduction

Intussusception Reduction – Hints from Ormazabal

Before getting started, must have:

In the room, must have:

Can use air or water soluble contrast—peds rads usually start with air, unless abd film shows so much air that it may be hard to tell

If using water soluble contrast, can use Cystoconray or Hypaque

The seal is the name of the game—use a Foley catheter that is big enough, so it will give you the best seal (usually 24-28 French in kids >12 months)

Inflate balloon under fluoro, then pull to snug and tape well with foam tape

Inflate air until you confidently see air reflux into the small bowel (it’s “bubbly”)

Sustained pressure shouldn’t be higher than 120 mmHg

Give it 3 tries to try and reduce—in general, if making progress, keep going

If using water soluble contrast, elevate bag approximately 3 feet above table, to get a good pressure head

Image capture multiple spots as you go—it can be helpful if trying to convince yourself that you are in fact in the small bowel to go back and look at the spots as you progress.

Consent for the procedure should include risk of perforation necessitating surgery and risk of being unable to reduce intussusception thus necessitating surgery.