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DOI: 10.1055/s-2005-870360
Diagnostik und Therapie von Invaginationen bei Kindern
Diagnosis and Therapy of Intussusception in ChildrenPublication History
Publication Date:
08 September 2005 (online)
![](https://www.thieme-connect.de/media/rad-u2d/200503/lookinside/thumbnails/10.1055-s-2005-870360-1.jpg)
Zusammenfassung
Die Invagination ist eine der häufigsten Ursachen für ein akutes Abdomen im Kindesalter. Mit diesem Krankheitsbild wird auch der kinderradiologisch wenig erfahrene Radiologe konfrontiert. Ziel dieser Arbeit ist es, die typischen sonographischen Bilder der Invagination zu vermitteln und einen praktischen Leitfaden für die Therapie an die Hand zugeben. Denn auch mit geringer sonographischer Erfahrung ist die Diagnose im Ultraschall leicht zu stellen und - unter Beachtung gewisser Regeln - mit einem Einlauf oder Insufflation von Luft einfach zu behandeln.
Abstract
Intussusception is one of the most common causes of acute abdomen in children. Even radiologists who are unfamiliar with pediatric radiology encounter this problem. This paper discusses the typical sonographic indicators of intussusception and provides a practical guide for therapy. Diagnosing intussuception is easy, even for those with little experience in pediatric sonography. Taking a few rules into consideration, intussusception can be treated easily with hydrostatic or pneumatic reduction.
Key words
Intussusception, diagnosis; therapy, ultrasound, children, infants, gastrointestinal tract
Literatur
- 1 Navarro O, Daneman A. Intussusception. Part 3: Diagnosis and management of those with an identifiable or predisposing cause and those that reduce spontaneously. Pediatr Radiol. 2004; 34 305-312
- 2 Staatz G, Alzen G, Heimann G. Darminfektion, die häufigste Invaginationsursache im Kindesalter: Ergebnisse einer 10-jährigen klinischen Studie. Klin Pädiatr. 1998; 210 61-64
-
3 Harms H K, Hecker W Ch.
Invagination. In: Schulte, Spranger (Hrsg. ) Lehrbuch der Kinderheilkunde. Stuttgart; Gustav Fischer 1988: 305 - 4 Del-Pozo G, Albillos J C, Tejedor D, Calero R, Rasero M, De-la-Calle U, Lopez-Pacheco U. Intussusception in children: Current concepts in diagnosis and enema reduction. Radiographics. 1999; 19 299-319
- 5 Danemann A, Navarro O. Intussusception. Part 1: A review of diagnostic approaches. Pediatr Radiol. 2003; 33 79-85
- 6 Franken E A, Kao S C, Smith W L, Sato Y. Imaging of the acute Abdomen in infants and children. Am J Roentgenol. 1989; 153 921-928
- 7 Del-Pozo G, Albillos J C, Tejedor D. Intussusception. US findings with pathologic correlation - the crescent-in-doughnut sign. Radiology. 1996; 199 688-692
- 8 Feinstein K A, Myers M, Fernbach S K, Bhisitkul D N. Peritoneal fluid in children with intussusception: its sonographic detection and relationship to successful reduction. Abdom Imagin. 1993; 18 277-279
- 9 Alzen G, Berthold L D, Moritz D. Diagnosis and Clinical Signs of Small Bowel Intussusception. Radiology. 2002; 225(Suppl. 1) 618
- 10 Fishman M C, Borden S, Cooper A. The dissection sign of nonreducible ileocolic intussusception. Am J Roentgenol. 1984; 143 5-8
- 11 Daneman A, Navarro O. Intussusception. Part 2: An update on the evolution of management. Pediatr Radiol. 2004; 34 97-108
- 12 Royal S A. Hypovolemic shock after air reduction of intussusception. Pediatr Radiol. 2001; 31 184-186
- 13 Franken E A Jr, Smith W L, Chernish S M, Campbell J B, Fletcher B D, Goldman H S. The use of glucagon in hydrostatic reduction of intussusception: a double-blind study of 30 patients. Radiology. 1983; 146 687-689
- 14 Hsiao J Y, Kao H A, Shih S L. Intravenous glucagon in hydrostatic reduction of intussusception: a controlled study of 63 patients. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1988; 29 242-247
- 15 Katz M E, Kolm P. Intussusception reduction 1991: an international survey of pediatric radiologists. Pediatr Radiol. 1992; 22 318-322
- 16 Shiels W E, Kirks D R, Keller G L, Ryckman F R, Daugherty C C, Specker B L, Summa D W. Colonic perforation by air and liquid enemas: comparison study in young pigs. Am J Roentgenol. 1993; 160 931-935
- 17 Reihhardt D (Hrsg). Therapie der Krankheiten im Kindes- und Jugendalter. Springer 1997: 772-773
- 18 Barr L L, Stansberry S D, Swischuk L E. Significance of age, duration, ostruction and the dissection sign in intussusception. Petiatr Radiol. 1990; 20 454-456
- 19 Gonzalez-Spinola J, Del Pozo G, Tejedor D, Blanco A. Intussusception: the accuracy of ultrasound-guided saline enema and the usefulness of a delayed attempt at reduction. J Pediatr Surg. 1999; 34 1016-1020
- 20 Sandler A D, Ein S H, Connolly B, Daneman A, Filler R M. Unsucccessful air-enema reduction of intussusception: is a second attempt worthwhile?. Pediatr Surg Int. 1999; 15 214-216
- 21 Kohng P L, Peh W C, Lam C H, Chan K L, Dheng W, Lam W W, Ai V H, Saing H, Tam P K, Leong L L, Low L C. Ultrasound-guided hydrostatic reduction of childhood intussusception: technique and demonstration. Radiographics. 2000; 20 1818
-
22 Alzen G, Schmitz-Rode T.
Neue Techniken zur Behandlung der Invagination. In: Günther RW, Gockel HP (Hrsg) Jahrbuch der Radiologie 1992. Zülpich; Biemann 1992: 143-151 - 23 Schmitz-Rode T, Müller-Leisse C, Alzen G. Comparative examination of various rectal tubes and contrast media for the reduction of intussusceptions. Pediatr Radiol. 1991; 21 341-345
- 24 Daneman A, Alton D J, Ein S, Wesson D, Superina R, Thomer P. Perforation during attempted intussusception reduction in children-a comparison of perforation with barium and air. Pediatr Radiol. 1995; 25 81-88
- 25 Zheng J Y, Frush D P, Guo J Z. Review of pneumatic reduction of intussusception: evolution not revolution. J Pediatr Surg. 1994; 29 93-97
- 26 Gu L, Wong S, Gu A. Perforations during attempted intussusception reduction: 14 patients from 9028 examinations over a 20-year period. J Intervent Radiol. 1993; 2 36-38
- 27 Bramson R T, Blickman J G. Perforation during hydrostatic reduction of intussusception: proposed mechanism and review of the literature. J Pediatr Surg. 1992; 27 589-591
- 28 Maoate K, Beasley S W. Perforation during gas reduction of intussusception. Pediatr Surg Int. 1998; 14 168-170
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