�nvajinasyonda ba�ar�s�z pn�matik red�ksiyon ve reinvajinasyon olgular�n�n incelenmesi

�zcan, Rah�an; H�seynov, Mirzaman; Emre, �enol; T�t�nc�, �i�dem; Vehid, Hayriye Ertem; Dervi�o�lu, Serg�len; Adaletli, �brahim; Celayir, Sinan; Tekant, Gonca

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�nvajinasyonda ba�ar�s�z pn�matik red�ksiyon ve reinvajinasyon olgular�n�n incelenmesi [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2016; 22(3): 259-264 | DOI: 10.5505/tjtes.2016.79851

�nvajinasyonda ba�ar�s�z pn�matik red�ksiyon ve reinvajinasyon olgular�n�n incelenmesi

Rah�an �zcan¹, Mirzaman H�seynov¹, �enol Emre¹, �i�dem T�t�nc�², Hayriye Ertem Vehid³, Serg�len Dervi�o�lu⁴, �brahim Adaletli⁵, Sinan Celayir¹, Gonca Tekant¹
¹�stanbul �niversitesi, Cerrahpa�a T�p Fak�ltesi, �ocuk Cerrahisi Ana Bilim Dal�,i̇stanbul
²�stanbul �niversitesi, Cerrahpa�a T�p Fak�ltesi, Anesteziyoloji Ana Bilim Dal�,i̇stanbul
³�stanbul �niversitesi, Cerrahpa�a T�p Fak�ltesi, Biyoistatistik Ana Bilim Dal�,i̇stanbul
⁴�stanbul �niversitesi, Cerrahpa�a T�p Fak�ltesi, Patoloji Ana Bilim Dal�,i̇stanbul
⁵�stanbul �niversitesi, Cerrahpa�a T�p Fak�ltesi, Radyoloji Ana Bilim Dal�,i̇stanbul

AMA�: �nvajinasyon tedavisinde pn�matik red�ksiyon (PR) ile ba�ar�s�z olunan olgular ve PR ile tedavi sonras� tekrar invajinasyon geli�en olgular�n de�erlendirilmesidir.
GERE� VE Y�NTEM: 2003�2014 y�llar� aras�nda invajinasyon nedeni ile tedavi edilen 401 olgunun kay�tlar� geriye d�n�k olarak incelendi. Bu �al��maya al�nan 61 olgunun 20�si (Grup 1) ba�ar�s�z PR ve 41�i (Grup 2) ba�ar�l� red�ksiyon sonras� tekrar invajinasyon geli�en olgulard�. Uygulanan tedavi ve sonu�lar� incelendi.
BULGULAR: Grup 1�de (ya� ortalamas�: 14.2 ay) operasyon endikasyonu 15�inde ba�ar�s�z PR ve be�inde PR s�ras�nda perforasyondu. Bu be� olgunun tamam� bir ya� alt�ndayd� ve ortalama ba�vuru zaman� �� g�n (2�4 g�n) idi. Laparatomide ek patoloji olarak; olgular�n 15�inde mezenterik lenfadenopati ve/veya peyer plak hiperplazisi, be�inde meckel divertik�l� saptand�. Grup 2�de (ya� ortalamas�: 20 ay) reinvajinasyon en s�k ilk 24 saatte (n=21) g�r�ld�. K�rk bir olgunun 36�s�nda reinvajinasyon PR ile tedavi edildi, be�ine laparotomi yap�ld�. Operasyon bulgular� d�rd�nde mezenterik lenfadenopati ve birinde polip idi.
TARTI�MA: Pn�matik red�ksiyon invajinasyonu ve n�ksetme tedavisinde etkili ve g�venilir bir y�ntemdir. Ge� ba�vuru pn�matik red�ksiyon ba�ar�s�n� azaltmaktad�r. Ba�ar�s�z PR�de laparotomide genellikle lead point ile kar��la��l�r.

Anahtar Kelimeler: �nvajinasyon, pn�matik red�ksiyon, rek�rren invajinasyon.

A review of intussusception cases involving failed pneumatic reduction and re-intussusception

Rah�an �zcan¹, Mirzaman H�seynov¹, �enol Emre¹, �i�dem T�t�nc�², Hayriye Ertem Vehid³, Serg�len Dervi�o�lu⁴, �brahim Adaletli⁵, Sinan Celayir¹, Gonca Tekant¹
¹Department Of Pediatric Surgery, �stanbul University, Cerrahpa�a Medical Faculty,i̇stanbul, T�rkiye
²Department Of Anesthesiology, �stanbul University, Cerrahpa�a Medical Faculty,i̇stanbul, T�rkiye
³Department Of Biostatistics,i̇stanbul University, Cerrahpa�a Medical Faculty,i̇stanbul, T�rkiye
⁴Department Of Pathology,i̇stanbul University, Cerrahpa�a Medical Faculty,i̇stanbul, T�rkiye
⁵Department Of Radiology,i̇stanbul University, Cerrahpa�a Medical Faculty,i̇stanbul, T�rkiye

BACKGROUND: The aim of the present study was to evaluate cases in which intussusception was unsuccessfully treated with pneumatic reduction (PR), and intussusception recurred following PR.
METHODS: The medical records of 401 patients who presented with intussusception between 2003 and 2014 were retrospectively analyzed. Included were 61 patients, 20 of whom underwent unsuccessful PR (Group 1), and 41 of whom experienced intussusception recurrence following PR (Group 2). Treatment and outcome were summarized.
RESULTS: In Group 1 (mean age: 14.2 months; range: 2.5 months�6 years) surgery was indicated due to PR failure in 15 patients, and perforation occurred during PR in 5. In these 5 patients, age was under 1 year (range 6�9 months) and mean time to presentation was 3 days (range 2�4). During laparotomy, pathologies were noted: mesenteric lymphadenopathy (LAP) and/or Peyer�s patch hyperplasia was observed in 15 cases, Meckel�s diverticulum in 5 cases. In Group 2 (mean age: 20 months; range: 3 months�6 years), intussusception developed after successful PR in 41 patients, most frequently within the first 24 hours (21.51%). Of the 41 patients, recurrent intussusception (RI) was treated with PR in 36, and laparotomy in 5. Operative findings were mesenteric LAP in 4 and polyp in 1.
CONCLUSION: PR is effective for the treatment of intussusception and recurrences. Delayed presentation reduces the success rate. In the event of failure, a lead point is usually encountered at laparotomy.

Keywords: Intussusception, pneumatic reduction, recurrent intussusception.

Rah�an �zcan, Mirzaman H�seynov, �enol Emre, �i�dem T�t�nc�, Hayriye Ertem Vehid, Serg�len Dervi�o�lu, �brahim Adaletli, Sinan Celayir, Gonca Tekant. A review of intussusception cases involving failed pneumatic reduction and re-intussusception. Ulus Travma Acil Cerrahi Derg. 2016; 22(3): 259-264

Sorumlu Yazar: Rah�an �zcan, T�rkiye
Makale Dili: �ngilizce

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