Materiały źródłowe

• #1 Intussusception: What It Is, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/10793-intussusception

  Theres no way to prevent intussusception. But, you can take steps to avoid the worst outcomes by getting your child emergency treatment immediately. […] The prognosis is excellent for children treated early. An air or contrast enema usually cures intussusception. Intussusception recurs in 10% to 20% of children, with symptoms returning within the first 48 hours after surgery (less common) or weeks or months later (more common). […] A barium or air enema is successful in up to 85% of children treated in hospitals where providers have experience treating intussusception. You can improve your childs chances of survival (with no complications) by getting them diagnosed and treated as soon as you notice symptoms.

• #2 Intussusception – familydoctor.org

  https://familydoctor.org/condition/intussusception/

  Since the there is no known cause, there is no way to prevent or avoid intussusception.

• #3 Intussusception Symptoms, Treatment, Surgery, Diet, Success

  https://www.emedicinehealth.com/intussusception_in_babies_children_and_adults/article_em.htm

  Can Intussusception In Babies, Children, and Adults Be Prevented? Intussusception generally cannot be prevented.

• #4

  https://step2.medbullets.com/pediatrics/120611/intussusception

  there are no preventive measures available at this time

• #5 Intussusception and Small Bowel Obstruction – Dr AvinashTank, is a super-specialist (MCh) Laparoscopic Gastro-intestinal Surgeon,

  https://dravinashtank.in/gastro_health/intussusception-and-small-bowel-obstruction/

  Intussusception is a condition where one part of the intestine telescopes or slides into another, causing an obstruction. […] Since the cause of intussusception is often unknown, specific prevention measures are challenging. Early diagnosis and prompt medical care are key to preventing complications. […] While prevention is challenging, early intervention can help minimize complications.

• #6 Current diagnosis and image-guided reduction for intussusception in children

  https://www.e-cep.org/journal/view.php?doi=10.3345/cep.2021.01816

  Intussusception involves an invagination of the proximal bowel into the distal bowel, with ileocolic intussusception being the most common type. […] Nonoperative enema reduction, the treatment of choice for childhood intussusception in cases without signs of perforation or peritonitis, can be safely performed with a success rate of 82%. […] Successful enema reduction is less likely to be achieved in children with a longer symptom duration, younger age, lethargy, fever, bloody diarrhea, unfavorable radiologic findings (small bowel obstruction, trapped fluid, ascites, absence of flow in the intussusception, intussusception in the left-sided colon), and pathological lead points. […] Nonoperative enema reduction is the treatment of choice for childhood intussusception unless there are signs of perforation or peritonitis.

• #7 Current diagnosis and image-guided reduction for intussusception in children

  https://www.e-cep.org/journal/view.php?doi=10.3345/cep.2021.01816

  Pneumatic reduction under fluoroscopic guidance is the most widely used and effective method of nonoperative enema reduction, with a high success rate and low perforation rate. […] Hydrostatic enema reduction under ultrasonographic guidance has been increasingly used because of comparable success rates and low perforation rates, with the major advantage of avoiding radiation exposure. […] A delayed repeat enema is recommended when the first attempt partially reduces the intussusception and the patient shows stable vital signs and no signs of peritonitis. […] Nonoperative reduction is generally unsuccessful in the treatment of small bowel intussusception, and enema reduction is not recommended except in certain conditions of concomitant ileocolic or ileoileal intussusception occurring near the ileocecal valve. […] Surgical management is indicated for children with recurrent intussusception if it is irreducible by enema reduction or pathologic lead points are documented through imaging studies.

• #8 Reduction of intussusception under general anesthesia by hydrostatic technique: the RIGHT technique | Annals of Pediatric Surgery | Full Text

  https://aops.springeropen.com/articles/10.1186/s43159-021-00076-w

  The RIGHT technique is a combination of the best available techniques of reduction of intussusception. It ensures patient safety by being performed in the OR, being pain free, avoiding radiation, avoiding the risk of aspiration associated with sedation, and also being able to immediately address a failure of reduction or a complication by surgical exploration. […] The aim of the present study is to find an ideal environment which is very safe for the patient, comfortable for the operators and flexible enough to promptly deal with any complication. […] The RIGHT (Reduction of Intussusception under General anesthesia using Hydrostatic Technique) method is a combination of the best available techniques of non-operative reduction of intussusception. It ensures utmost patient safety and comfort by being performed in the controlled environment of the OR, being pain free, avoiding radiation exposure, avoiding the risk of aspiration associated with sedation, and also being able to immediately address a failure of reduction or a complication like perforation by surgical exploration without any delay.

• #9 The clinical study on conservative therapy of pediatric intussusception: caudal block improves the success rate – Kim – Art of Surgery

  https://aos.amegroups.org/article/view/6323/html

  Caudal block in combination with intramuscular ketamine is very effective one that can raise the success rate (93.9%) for repair as well as shorten repair times and necessary time. […] Caudal block in combination with sedation can improve the condition for reduction of intussusception by providing sufficient muscle relaxation. […] The caudal block in combination with ketamine improved the success rate (approximately 93.9%) of reduction of intussusception and shorten the necessary time for reduction as well as did not affect a negative effect on the hemodynamic and respiratory function.

• #10 Enteroplication for the prevention of intussusception recurrence in dogs: 31 cases (1978–1992) in: Journal of the American Veterinary Medical Association Volume 205 Issue 1 (1994)

  https://avmajournals.avma.org/view/journals/javma/205/1/javma.1994.205.01.72.xml

  Medical records of 31 dogs that had undergone surgery for correction of intussusception during a 14-year period were reviewed. Enteroplication was performed on 9 dogs during the initial surgery, and intussusception did not recur in any of these dogs. […] Enteroplication was performed in 4 dogs following surgical correction of recurrence of an intussusception, and further recurrences were not seen in any of these dogs. Enteroplication did not cause any apparent adverse effects and decreased the probability of recurrence of intussusception in these dogs.

• #11

  https://journals.lww.com/aamj/fulltext/2017/15040/ileopexy_in_open_reduction_of_ileocolic.8.aspx

  Intussusception is the main reason of intestinal obstruction in pediatrics. Hydrostatic reduction (HR) is the cornerstone in its treatment. However, surgical treatment is indicated in case of failure of HR. Fixation of terminal ileum (ileopexy) has been used to reduce or even prevent recurrence of intussusception, but its outcome has not been well studied. […] The aim was to investigate the effect of fixation of terminal ileum on recurrence rate after surgical reduction of intussusception in pediatric age group. […] In addition, the recurrence rate was nonsignificantly reduced in group A when compared with group B (5.0 vs. 15.0%, respectively). […] Fixation of terminal ileum during surgical reduction of intussusception is safe, feasible, and simple technique. It results in reduction of the recurrence rate. However, the difference was statistically nonsignificant.

• #12

  https://journals.lww.com/aamj/fulltext/2017/15040/ileopexy_in_open_reduction_of_ileocolic.8.aspx

  However, literature is deficient in studies investigating the association between methods of operative intervention and the incidence of intussusception recurrence for each procedure. […] Here, we reported our experience with fixation of the terminal ileum after manual reduction of intussusception. Our study included 80 children fulfilling the indications for surgical intervention. All patients were subjected to surgical reduction with fixation of the ileum in group A and no fixation of the ileum in group B to compare the effect of fixation of the ileum on the recurrence of intussusception. […] Thus, we can say that fixation of terminal ileum to ascending colon potentially had a benefit of reducing recurrence rate, although the difference was statistically nonsignificant. […] The recurrence rate in the present work was 10% regardless of the technique, and this is lower than that reported by Esmaeili-Dooki et al.

• #13

  https://journals.lww.com/aamj/fulltext/2017/15040/ileopexy_in_open_reduction_of_ileocolic.8.aspx

  The fixation of terminal ileum to the ascending colon seems to be more suitable method for reduction of recurrence rate. However, the present study did not confirm this assumption. […] In short, fixation of terminal ileum was potentially better than simple reduction in minimizing recurrence of intussusception in children. However, the difference was statistically nonsignificant, and future studies with larger sample of patients are needed.

• #14 Intussusception after reconstruction following gastrectomy for gastric cancer | World Journal of Surgical Oncology | Full Text

  https://wjso.biomedcentral.com/articles/10.1186/s12957-021-02456-3

  For patients undergoing gastrectomy, it should be noted during the operation that [1] The jejunal feeding tube should not be inserted too close to the anastomosis [2]; the tension should be balanced during jejunal side-to-side anastomosis, and the intestinal canal should not be suspended at an angle [3]; the intraoperative maneuvers should be gentle to minimize the stimulation to the intestinal canal, and the small intestine itself should be carefully examined for pathological changes [4]; when inserting the nasoenteric feeding tube, the intestinal canal should not be forcefully pushed and pulled to send the feeding tube to the distal end, and the other professionals in the operating room should inject normal saline into the feeding tube to dilate and insert the small intestine at the same time, the surgeon cooperates to straighten the feeding tube, prevent bending, and also avoid intestinal shrinkage and overlap [5]; the anastomosis should not be too long, 10 cm-15 cm can be used. The jejunal feeding tube should be properly fixed in the perioperative period; the balloon of the jejunal feeding tube should not be overfilled to reduce the irritation to the small intestinal wall during catheterization. After reconstruction, the patient should get out of bed as early as possible, or they should be in a semi-decubitus position to prevent intra-abdominal adhesions. At the same time, the starting time and speed of feeding through the jejunal feeding tube should be adjusted, which should not be premature. Feeding should be started when the patient has spontaneous peristalsis in the gastrointestinal tract. The infusion rate of nutrition should be coordinated with the degree of recovery of gastrointestinal function; the jejunal feeding tube should have a sufficient number of side holes, as well as the stimulation of dispersed food to the small intestinal wall. After gastrojejunal reconstruction, the patient should eat small meals and less irritating food.

• #15

  https://www.vin.com/apputil/content/defaultadv1.aspx?id=3866527&pid=11268

  Intussusception: Diagnosis and Treatment World Small Animal Veterinary Association World Congress Proceedings, 2008 Pierre Barreau, DVM, DECVS, MRCVS Limoges, France […] […] Several surgical techniques to prevent recurrence have been recommended in the past including Noble or Childs-Phillips plication, enteropexy. […] The efficacy of plication as a prophylactic measure have not been demonstrated. […] Some authors recommend that the entire intestine should be plicated, the bends in the intestine should be gentle and that plication sutures should be placed at intervals that prevent entrapment and strangulation of other portions of the bowel. […] However the use of perioperative opioids for sedation and analgesia seems to have considerably reduced the recurrence rate in the latest studies. The incidence was reduced from 17 to 3 % in dogs undergoing experimental renal transplantation. It was hypothesized that the use of opioids result in increased tone of the small intestine with increased amplitude of the non propulsive rhythmic segmental contractions. This was believed to reduce or prevent local bowel wall inhomogeneity and segmental ileus therefore decreasing the likelihood of intussusception.

• #16 No Prophylactic Antibiotic Use for Young Children’s Intussusception with Low-risk Infection after Successful Air Enema Reduction | Scientific Reports

  https://www.nature.com/articles/s41598-018-24415-x

  The Chinese government has issued the policy of promulgating the clinical use of antibacterial drugs since 2011. Prophylactic antibiotic use is a challenging problem among young children with intussusception after successful air enema reduction. […] Prophylactic antibiotics appeared to be of little value after the successful air enema reduction of intussusception in young children with low-risk infection. Policy intervention is effective for antibiotic use in China. […] Based on our findings, we suggest that its unnecessary to use prophylactic antibiotic for young childrens intussusception with low-risk infection.

• #17 Addition of History of Intussusception as a Contraindication for Rotavirus Vaccination

  https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6041a5.htm

  Intussusception is a telescoping of one portion of the intestine into another, which can result in bowel obstruction and subsequent bowel ischemia. […] Compared with infants who have never had intussusception, infants with a history of intussusception are at greater risk for intussusception. […] Specific data, however, are not available on the risk for a subsequent episode of intussusception following rotavirus vaccination of infants with a history of intussusception. […] Rotavirus vaccination is now contraindicated for 1) infants with a history of severe allergic reaction (e.g., anaphylaxis) after a previous dose of rotavirus vaccine or exposure to a vaccine component, 2) infants diagnosed with severe combined immunodeficiency (SCID), and 3) infants with a history of intussusception.

• #18 Intussusception: Symptoms, Causes in Children & Adults

  https://www.health.com/intussusception-8678470

  Because the cause of intussusceptions in children is usually unknown, prevention is difficult. All you can do is watch for symptoms of possible recurrence. Children typically get intussusception at 6-18 months, meaning they probably won’t be able to verbalize when something hurts and where it hurts. […] Prevention is also challenging in adults because there is usually another underlying medical condition causing the intussusception. Fortunately, intussusception is rare in adults, and your recurrence rate is minimal. Eating a high-fiber diet and staying well-hydrated may reduce the risk of intussusception and prevent recurrence.

• #19 Treatment of adult idiopathic ileocolic intussusception with non-operative reduction under fluoroscopic guidance

  https://www.oatext.com/Treatment-of-adult-idiopathic-ileocolic-intussusception-with-non-operative-reduction-under-fluoroscopic-guidance.php

  Intestinal intussusception is rare in adults, often associated with a malignant lesion and usually requires surgery. […] Preoperative reduction is not often performed because of theoretical risks such as intraluminal seeding/venous tumor dissemination, perforation and perceived increased risk of anastomotic complications in case surgery is required. […] However, such as in our case, non-operative reduction can be attempted when the lead point is thought to be benign or unclear (idiopathic). […] Therefore non-surgical reduction should be performed only by an experienced clinician, preferably with pre-procedural consultation with a surgical team for back up in the case of perforation or other complications. […] In conclusion, we reported a case of adult idiopathic ileocolic intussusception which was successfully treated with non-operative reduction under fluoroscopic guidance.

• #20 Intussusception in Dogs

  https://www.thesprucepets.com/treating-intussusception-in-dogs-4768651

  Prevention of intussusception can be difficult, but promoting a healthy intestinal tract may help. […] Regular use of intestinal parasite prevention, gradual dietary changes, and ensuring your dog doesn’t eat foreign objects can help decrease the chances of this condition occurring in your dog.

• #21 Intussusception in Horses – Causes, Treatment and Associated Conditions – Vetster

  https://vetster.com/en/conditions/horse/intussusception

  There are no proven preventive measures for intussusception. Good gastrointestinal health is promoted by feeding many small meals throughout the day, offering plenty of fresh water, and ensuring daily exercise.

• #22 Intussusception in Horses: Risk Factors, Treatment & Prognosis | Mad Barn

  https://madbarn.com/intussusception-in-horses/?srsltid=AfmBOoosv0MyEnJoor1fpk5iVwwtpv0XzjSRH81sPwOCYsqX2Z7Gs3VE

  Since the causes of intussusception are not fully understood, prevention measures are limited. There are some preventive strategies owners can take based on its known risk factors. Strategies include: […] Gradually making dietary changes over a period of weeks […] Following best management practices to prevent ulcer development, particularly by feeding a free-choice, forage-based diet […] Providing sufficient exercise and socialization to reduce stress and associated gut dysfunction […] Monitoring horses carefully after abdominal surgery […] Using appropriate dewormers at a schedule determined with oversight from a qualified veterinarian.

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