Effect of hydrocortisone on improving the outcome of pneumatic reduction in infantile intussusception

Document Type : Original Article

Authors

1 Departments of Pediatric Surgery, Faculty of Medicine, Helwan University, Egypt

2 Department of Pediatric Surgery, Faculty of Medicine, Ain Shams University, Egypt

3 Departments of General Surgery, Faculty of Medicine, Helwan University, Egypt

Abstract

Introduction: Intussusception is the most common cause of infantile acute intestinal obstruction counting about 53% of all the intestinal obstruction cases under 2 years of age.
Aim: To assess the effect of hydrocortisone on the outcome of pneumatic reduction of primary intussusception in infants.
Methods: From August 2022 to November 2023, a non-randomized controlled trial of infants with intestinal obstruction due to primary intussusception were included (Group I). Included cases were injected with intravenous hydrocortisone (10 mg/kg) during resuscitation before attempting reduction. The results were compared with a historical group of cases who presented during the same time interval the year before (Group II). Those patients didn’t receive steroids during the resuscitation phase. Vitally unstable cases, cases with peritonitis, history of open or laparoscopic reduction, and cases diagnosed as secondary intussusception were excluded from the study.
Results: Group I included 30 patients (18 males and 12 females) aged 3 to 24 months, while group II contained 34 patients (23 males and 11 females) aged 5 to 19 months. The duration of symptoms was < 72 hours in 25 patients in group I, in contrast to 27 patients in group II. There were no statistically significant differences regarding gender, age, and duration of symptoms (P values were 0.525, 0.165, and 0.821 respectively). Pneumatic reduction was successful in 24 patients (80%) in group I, compared to 21 patients (61.8%) in group II. The use of intravenous hydrocortisone was associated with increased success of pneumatic reduction in group I in relation to group II (OR = 2.48, 95% CI [0.7992 to 7.6718]); however, the statistical difference was non-significant (P value = 0.1161).
Conclusion: The use of hydrocortisone in the resuscitation of intussusception cases clinically affects the success rates of the first trial of pneumatic reduction; however, that effect is statistically non-significant.

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