Spontan Redüksiyon Sonucu Geçici İnvajinasyon Tanısı Alan Pediatrik Olguların Demografik, Klinik ve Radyolojik Özellikleri

Year 2024, , 55 - 59, 10.01.2024

Aziz Serhat Baykara

https://doi.org/10.12956/tchd.1353615

Abstract

Amaç: Geçici invajinasyon, ince bağırsağın bir kısmının teleskopik olarak bağırsağın ön kısmına girdiğinin tespit edildiği ancak takip sırasında bu durumun kendiliğinden düzeldiği bir durumdur. Tanı araçları arasında ultrasonografinin yaygınlaşması ile birlikte bu durumun görünürlülüğü artmıştır. Bu çalışmada kliniğimizde spontan azalma ile sonuçlanan invajinasyon olgularının sunulması amaçlandı.

Gereç ve Yöntemler: Ocak 2014 ile Eylül 2022 tarihleri arasında invajinasyon tanısı alan bütün olguların kayıtları tarandı. Gözlem sonucunda geçici invajinasyon tanısı konulan hastaların dosyaları incelendi. Yaş, cinsiyet, klinik bulgular, başvuru süresi, ultrasonografi bulguları, tedavi seçenekleri ve sonuçları retrospektif olarak incelendi.

Bulgular: İnvajinasyon tanısı alan 50’si erkek, 21’i kız çocuğu olmak üzere toplam 71 olgunun yaş ortalaması 22.3 aydı. İnvajinasyon 36 hastada ileokolik, 32 hastada ileo-ileal ve 3 hastada jejuno-jejunaldi. Peritoneal irritasyon bulgusu olmayan ve kısa segment tutulumu olan 33 (%21) ince barsak invajinasyonlu hastaya fizik muayene ve ultrasonografi ile klinik gözlem yapıldı. Dört hastada gözlem sonrası invajinasyonun devam etmesi nedeniyle cerrahi redüksiyon uygulandı. Geri kalan 29 hastaya 12 saat sonra yapılan kontrol ultrasonunda invajinasyon görüntüsünün kaybolduğu görüldü. Geçici invajinasyon tanısı alan 29 hastanın yaş aralığı 10 ile 122 ay (ortalama 46.2 ay) arasında değişiyordu. Olguların 19’u (%65.5) erkek, 10’u (%34.4) kadındı. İnvaginasyonlu segmentin uzunluğu 1-2.2 cm (ortalama 1.8 cm) arasında değişiyordu.

Sonuç: Akut batın bulguları olmayan ve ultrasonda kısa segment tutulumu ile seyreden ince barsak invajinasyonlarında klinik gözlem sonucu spontan redüksiyon meydana gelebilir. Bu nedenle spontan redüksiyon gelişebilecek uygun vakaların yakın takibi, gereksiz cerrahi müdahalelerin ve sonuçlarının önlenmesi açısından önemlidir.

Keywords

Çocuk, İnvajinasyon, Geçici, Spontan redüksiyon

Demographic, Clinical and Radiological Characteristics of Pediatric Cases Diagnosed As Transient Intussusception As A Result of Spontaneous Reduction

Abstract

Objectives: Transient intussusception (TI) is a condition in which part of the small intestine is identified to enter the anterior part of the intestine telescopically, but this condition spontaneously reduces during follow-up. The observation of this situation has increased with the widespread use of ultrasonography among diagnostic tools. In this study, the aim was to present cases of intussusception that resulted in spontaneous reduction in our clinic.

Materials and Methods: The records of cases diagnosed with intussusception between 01.01.2014 and 01.09.2022 were scanned. The files of the patients who were diagnosed with TI as a result of observation were investigated. Age, gender, clinical findings, duration of admission, ultrasonography findings, treatment options and results were analyzed retrospectively.

Results: A total of 71 cases diagnosed with intussusception included 50 males and 21 females, with a mean age of 22.3 months. Intussusception was ileo-colic in 36 patients, ileo-ileal in 32 patients, and jejuno-jejunal in three patients. Clinical observation with physical examination and ultrasonography (US) was performed in 33 (21%) patients with SBI who did not have signs of peritoneal irritation and had short segment involvement. Surgical reduction was performed in four patients because intussusception persisted after observation. Control US performed on the remaining 29 patients showed that intussusception disappeared. The age range of 29 patients diagnosed with TI ranged from 10 to 122 months (mean 46.2 months). Of the cases, 19 (65.5%) were male and 10 (34.4%) were female. The length of the invaginated segment ranged from 1-2.2 cm (mean 1.8 cm).

Conclusion: Spontaneous reduction of SBI, which does not have acute abdominal findings and progresses with short segment involvement on US, may occur during clinical observation. For this reason, close follow-up of suitable cases that may develop spontaneous reduction is important to avoid unnecessary surgical interventions and consequences.

Keywords

Child, Intussusception, Transient, Spontan reduction

Ethical Statement

The study was approved by Health Sciences University in the Eskisehir City Hospital, Clinical Research Ethics Committee (Approval No: ESH/GOEK 2023/34, 20.06.2023)

Supporting Institution

This article did not receive any specifik grnat from funding agencies in the public, commecial, or not-for-profit sectors.

Thanks

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