Browsing by Author "Lukač, Marija (7003769857)"

Introduction Intussusception is a common abdominal emergency in early childhood. It is idiopathic in more than 90% of cases with incidence of 1.5-4 per 1,000 live births. The treatment of choice is non-operative hydrostatic or air enema reduction. Objective The aim of the study was to evaluate the influence of clinical presentation and symptom duration in non-operative treatment, considering the indications for delayed enema reduction and its efficacy. Methods From the total number of 107 patients with intusussception, aged from 2 months to 14 years (median 9 months), 102 (95%) patients with ileo-colic intussusceptions were treated initially by ultrasound guided saline enema. Records were reviewed for patients with failed initial treatment and delayed repeated enemas or operative procedure. The predictor variable included duration of presenting symptoms. Results Successful treatment by hydrostatic saline enemas had 58/102 (57%) patients. Success in reduction was greater if symptom duration was <24 hours (54/62 cases; 87%, p<0.001), compared with >24 hours, (4/45 cases; 9%). Despite failed initial attempts, enema reduction was reattempted in 12 patients, with success in 7/12 (60%) patients. Children with symptom duration >24 hours had a greater risk of requiring surgery (41/45 cases; 91%, p<0.001), including 5 (5%) patients with ileo-ileal intussusceptions. Conclusion The accuracy of ultrasound guided saline enema in intussusception reduction is high. Delay in presentation decreases success of non-operative treatment. Delayed enema reduction is important therapeutic option for intussusceptions. Surgical treatment is indicated in cases of complications. © 2014, Serbia Medical Society. All rights reserved.

Introduction Ileostomy represents a necessary procedure to solve various surgical diseases in children. As the result of increased fluid loss and colonic exclusion in its regulation, it is often followed, particularly during the first months after birth, by chronic dehydration and failure to thrive. Objective The aim of the paper was to present our experience related to the application of oral rehydration solution (ORS) to compensate the intestinal loss of water and electrolytes in infants with ileostomy. Methods Treatment was performed with ORS containing 65 mmol/L of sodium in five infants aged 1.5-8 months (3.8±2.46 months) with dehydration and undernutrition after ileostomy performed in the first five days after birth. Results After rehydration, the continual application of ORS in the daily dosage of 63.90±25.03 ml/kg, i.e. approximately matching the volume of intestinal content elimination (57.00±19.23 ml/kg), resulted in all infants in optimal water and electrolyte homeostasis, and in further course also in the improvement of their nutritional status (p=0.023). Conclusion Our experience indicates that continual application of reduced sodium content of ORS in the approximate equal quantity of intestinal content loss represents the method of choice in water and electrolyte homeostasis maintenance in infants with ileostomy.