Epub 2022 Feb 15. Tubbs RS, Performance of Deep Learning-Based Algorithm for Detection of Pediatric Intussusception on Abdominal Ultrasound Images. Prior reviews of nonsurgical management (Applegate 2009; Cachat 2012; Daneman 2003; Gray 2014; Ko 2007) are narrative in nature. Any child, younger than age 18, with a clinical diagnosis of intussusception as determined by study authors. official website and that any information you provide is encrypted Of the six trials identified, we considered all to be potentially biased owing to lack of detail in reporting of how each study was undertaken. Franken, These six completed trials were published in five different journals. We did not perform a quantitative analysis of this outcome owing to poor reporting and high risk of bias. et al. Dykes EH. No disagreements about trial selection among review authors required adjudication. PRISMA flow diagram of literature search and exclusion, MeSH Babies and young children are more likely than adults to get intussusception. Intussusceptionin early childhood: a cohort study of 1.7 million children. Nakamura K, Outcomes should be standardised and data related to safety and harm should be included. Debate also surrounds the best approach for its surgical management (i.e. Kosloske AM, It is more common in infants and children than it is in adults. For example, glucagon is an antispasmodic adjuvant used by 10% to 21% of surveyed practitioners (Cachat 2012; Katz 1992; Meyer 1992; Rosenfeld 1999). Evidence is current to September 2016. 21. Question 3: Does the administration of glucagon improve the rate of radiological reduction in children with acute intestinal intussusception? Intussusception and Volvulus in Children: Symptoms and Treatment A tumor or polyp (a growth inside the intestine) Intussusception is the most common cause of intestinal blockage in children between 3 months and 3 years of age. ACW: drafting the protocol and providing methodological advice. Sorge I, Although the Brighton Collaboration established a validated and standardised case definition (Bines 2004a; Bines 2004b; Kohl 2008; Tapiainen 2006), this definition has been used only in the context of rotavirus vaccine post licensure monitoring. The ClinicalTrials.gov, Embase, PubMed, and Scopus databases were queried for literature from January 1988 through December 2018. However, data on postoperative complications for the nine children undergoing manual reduction were not available. eCollection 2022. Razavi SA, PisonChacon J, It is unclear whether this was adequate to ensure random sequence generation in Hadidi 1999; in Meyer 1993, the randomisation process was compromised by the need to extrapolate data for participants with confirmed intussusception; and Mortensson 1984 applied inadequate sequence generation by using birth dates to randomly allocate participants. Cultures and probiotics help replenish healthy gut bacteria killed by antibiotics. Recurrence rates after intussusception enema reduction: a metaanalysis. We described results while taking into account the quality of evidence and the importance (size) of the effect as follows. This review used subsets of data from two trials (Meyer 1993; Mortensson 1984). When there is clinical suspicion, imaging has a valuable role. 5. Randomly.ab. The evidence base for this topic is lacking and must be developed further. As recurring intussusception is associated with differing outcomes (Applegate 2009), when possible we conducted our assessment with the participant as the unit of analysis. Intussusception - Children's Health Issues - MSD Manual Consumer Version Desselberger U, 6. All six included trials recruited participants referred for management of intussusception in a hospital setting. Intussusception in children is a medical emergency that requires prompt diagnosis and management. It is the most common cause of intestinal obstruction in this age group and occurs roughly equally in male and female children < 4 years of age . This list of 15 cases was used repeatedly throughout the study (10 times) with random sequence every time. This allocation sequence is predictable, No missing data (randomisation post exclusion). We conducted our analysis according to the guidelines set out in the Cochrane Handbook for Systematic Reviews of Interventions (Higgins 2011). Karp MP, Schmit P, Intussusception - Treatment algorithm | BMJ Best Practice Incidence ofintussusceptionamong infants in a large commercially insured population in the United States. Intestinal Intussusception: Etiology, Diagnosis, and Treatment This is both a diagnostic procedure and a treatment. These situations might reflect missing data, which may have implications for analysis. This site needs JavaScript to work properly. Careers. This causes an obstruction, preventing the passage of food that is being digested through the intestine. Intussusception risk after rotavirus vaccination in U.S. infants, Developing optimal search strategies for detecting clinically sound treatment studies in EMBASE, Journal of the Medical Library Association, The Cochrane Database of Systematic Reviews, Subgroup analysis and investigation of heterogeneity, Further research is very unlikely to change our confidence in the estimate of effect, Further research is likely to have an impact on our confidence in the estimate of effect and may change the estimate, Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate, Improves/decreases/prevents/leads to [outcome], Improves slightly/decreases slightly/leads to slightly fewer (more) [outcome], Results in little or no difference in [outcome], Probably improves/decreases/prevents/leads to [outcome], Probably improves slightly/decreases slightly/leads to slightly fewer (more) [outcome], Probably leads to little or no difference in [outcome], May improve/decrease/prevent/lead to [outcome], May slightly improve/slightly decrease/lead to slightly fewer (more) [outcome], May lead to little or no difference in [outcome], It is uncertain whether [intervention] improves, decreases, prevents, leads to [outcome] because the quality of the evidence is very low, [Outcome] was not measured or was not reported, or no studies were found that evaluated the impact of [intervention] on [outcome], Enema plus glucagon versus enema alone summary of findings table, Enema plus dexamethasone versus enema alone summary of findings table, Air enema versus liquid enema summary of findings table, New search performed. After treatment intussusception can come back (recur) - this happens in around 5 children for every 100 who are treated, reducing to 3 if the condition is treated surgically. Kre M, Two independent review authors undertook searching and data extraction and analysis, and a third review author provided arbitration. Hirschl RB, 2023 Jan-Dec;65(1):e15495. 16. Colonoscopic reduction of atransanal prolapsed ileocolic intussusception. In others, the potential for poorly perfused or dilated bowel to translocate and produce a bacteraemia is seen as an indication. PerezMartinez A, Intussusception can be life-threatening and requires immediate treatment. Allocation by judgement of the clinician; Allocation by preference of the participant; Allocation based on the results of a laboratory test or a series of tests; Allocation by availability of the intervention. Sleepiness/difficulty waking child up. Additional treatment recommended for SOME patients in selected patient group. This can lead to reduced blood flow to that part of the bowel. Altman DG. Both Essa 2011 and Franken 1983 referred to the random allocation used but provided no details. All included trials provided evidence of low quality and were subject to serious concerns about imprecision, high risk of bias, or both. This is usually the case if the method of concealment is not described or not described in sufficient detail to allow a definite judgement for example if the use of assignment envelopes is described, but it remains unclear whether envelopes were sequentially numbered, opaque and sealed. Comparison 2 Enema plus dexamethasone versus enema alone, Outcome 2 Bowel perforation(s). Davis RL, Desai R, One trial (Franken 1983) successfully blinded participants and personnel through the use of premade identical appearing vials of drug and placebo. Gargiullo PM, Insufficient information to permit judgement of Low risk or High risk. Study flow diagram for identification of randomised trials exploring management of intussusception in children. SoaresWeiser K, Intussusception is one of the most common abdominal emergencies for children younger than age three (Applegate 2009). Two infant deaths linked to intussusception without peritonitis. government site. Clipboard, Search History, and several other advanced features are temporarily unavailable. Huh YS, The GRADE system classifies the quality of evidence as one of four grades. 14. Therefore, it was necessary to extrapolate data from those with confirmed intussusception. Intussusception (see the image below) is a process in which a segment of intestine invaginates into the adjoining intestinal lumen, causing bowel obstruction. Management for intussusception in children - PMC It is a bit like a getting a sock turned inside itself. Hence, rotavirus vaccination is considered beneficial. Moss RL, No single study adequately reported all domains of the risk of bias assessment (Figure 2). Varlet F, When possible, we extracted the following primary and secondary outcome measures. Tan S, Your child was seen today in Children's Emergency Services and treated for . 15. trial.ti. Unauthorized use of these marks is strictly prohibited. Jumaan AO, It's the most common abdominal emergency in early childhood. A much stronger link between intussusception and an older rotavirus vaccine (RotaShield, Wyeth Laboratories, Marietta, Pennsylvania, USA) (Kramarz 2001; Murphy 2001; Peter 2002; SoaresWeiser 2004) led to its worldwide withdrawal in 1999. In rare cases, these events can cause death. Jooly Joseph and Madan Mohan Palliyil wrote an initial protocol for this review in 2007. Clinical trials in children present specific challenges, although randomised controlled trials in surgery are well documented. Two of these studies were performed in the USA (Franken 1983; Meyer 1993). Initial treatment includes obtaining adequate intravenous access and correction of hypovolaemia with isotonic fluid resuscitation. hospital emergency department, specialised paediatric hospital). Summary. Cochrane Database Syst Rev. Once intussusception is diagnosed, most doctors agree on the use of enema as initial treatment. Intussusception - Pediatrics - MSD Manual Professional Edition Only one trial reported postoperative complications, but owing to the method of reporting used, a quantitative analysis was not possible. Jiang J, The authors of the current review could not perform the comparison offered in both Daneman 2003 and Ko 2007 but agree with the findings of Ko 2007, which suggest that lack of standardisation among single studies makes objective comparison difficult. Buonomo C, A report prepared for the Steering Committee on Diarrhoeal Disease Vaccines, Vaccine Development,Vaccines and Biologicals, World Health Organization, Geneva, Switzerland.