Air intussusception reduction: "the winds of change". 1995

D R Kirks
Department of Radiology, Children's Hospital, Boston, MA 02115, USA.

AIR is an excellent example of the application of the scientific process to the treatment of pediatric disease. For more than 40 years, pediatric radiologists in North America were comfortable with hydrostatic enemas for the diagnosis and treatment of intussusception. Initial clinical trials in the 1980s suggested the efficacy of AIR. Subsequent clinical studies demonstrated that fluoroscopy time and radiation are less, accurate pressure measurements are possible, and reduction rates are higher with AIR than with hydrostatic techniques. Questions regarding safety and types of perforation were answered in the laboratory with an animal model. Moreover, this experimental work clarified issues regarding maximum pressures and the importance of the Valsalva maneuver during AIR. Experimental data has been transferred to the radiological treatment of childhood intussusception. The "winds of change", generated by clinical and basic research, have now swept across North America. More and more radiologists are performing AIR. Many of the pediatric radiologists who still doubt the efficacy of AIR have had no experience with the technique. Air insufflation is safe and effective for the diagnosis and treatment of intussusception in infants and children. It is replacing the hydrostatic enema in an ever-increasing number of institutions. AIR is quicker, safer, and more effective than hydrostatic enemas. If you are using AIR, I hope this overview will further improve the radiological care of your pediatric patients. If you are not using AIR, I hope that these personal observations will stimulate your interest. "Try it; you'll like it!"

UI MeSH Term Description Entries
D007416 Intestinal Perforation Opening or penetration through the wall of the INTESTINES. Intestinal Perforations,Perforation, Intestinal,Perforations, Intestinal
D007443 Intussusception A form of intestinal obstruction caused by the PROLAPSE of a part of the intestine into the adjoining intestinal lumen. There are four types: colic, involving segments of the LARGE INTESTINE; enteric, involving only the SMALL INTESTINE; ileocecal, in which the ILEOCECAL VALVE prolapses into the CECUM, drawing the ILEUM along with it; and ileocolic, in which the ileum prolapses through the ileocecal valve into the COLON. Invagination, Intestinal,Intususception,Intestinal Invagination,Intestinal Invaginations,Intussusceptions,Intususceptions,Invaginations, Intestinal
D011029 Pneumoradiography Radiography using air, oxygen, or some other gas as a contrast medium. Air Radiography,Insufflation Radiography,Negative Contrast Radiography,Radiography, Insufflation,Contrast Radiography, Negative,Radiography, Air,Radiography, Negative Contrast,Air Radiographies,Contrast Radiographies, Negative,Insufflation Radiographies,Negative Contrast Radiographies,Pneumoradiographies,Radiographies, Air,Radiographies, Insufflation,Radiographies, Negative Contrast
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003106 Colon The segment of LARGE INTESTINE between the CECUM and the RECTUM. It includes the ASCENDING COLON; the TRANSVERSE COLON; the DESCENDING COLON; and the SIGMOID COLON. Appendix Epiploica,Taenia Coli,Omental Appendices,Omental Appendix,Appendices, Omental,Appendix, Omental
D004733 Enema Insertion of a solution or compound through the RECTUM with the purpose of cleansing the COLON or for diagnostic procedures. Enemata,Enemas,Enematas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000388 Air The mixture of gases present in the earth's atmosphere consisting of oxygen, nitrogen, carbon dioxide, and small amounts of other gases.

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