Role of Dexamethasone as an adjuvant in the treatment of intussusception: A prospective study
Main Article Content
Background: Intussusception is one of the most commonly encountered abdominal emergencies in children for which the preferred treatment modality has always been non operative hydrostatic reduction. Recurrence is a common concern after a successful hydrostatic reduction. Adjuvant treatment with pharmacological agents have been considered to reduce chances of recurrence.
Aim: The study was conducted to examine the role of dexamethasone in decreasing early recurrent intussusception.
Materials and methods: A prospective cohort study was conducted in a tertiary care center from June 2018- June 2022 on 51 pediatric patients, admitted with intussusception and divided into a dexamethasone and non-dexamethasone group. Data was collected regarding demography, rate of recurrences, duration of hospital stay, surgery performed if any including the intraoperative findings and associated complications. The level of significance was set at 5%. SPSS version 27 was used to perform the statistical analysis.
Result: After ultrasound-guided hydrostatic reduction, the dexamethasone group showed significant reduction in recurrence, compared to the non-dexamethasone group. In this study, 7 cases showed recurrence despite three attempts of hydrostatic reduction and intraoperatively noted to have a pathological lead point.
Conclusion: Dexamethasone is one of the greatest discoveries of the 20th century with its vast use in multiple diseases. The use of dexamethasone during hydrostatic reduction of intussusception in a pediatric population makes it a wonderful drug with remarkable results and patient outcome.
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
2. Chukwubuike KE, Nduagubam OC. Hydrostatic reduction of intussusception in children: a single centre experience. Pan Afr Med J. 2020; 36:263. Published 2020 Aug 11. doi:10.11604/pamj.2020.36.263.21380
3. Mirza B. Recurrent intussusception: management options. APSP Journal of Case Reports. 2011 Jan;2(1):9. PMID: 22953276
4. Stringer MD, Pablot SM, Brereton RJ. Paediatric intussusception. Br J Surg. 1992;79(9):867-876
5. West KW, Stephens B, Vane DW, Grosfeld JL. Intussusception: current management in infants and children. Surgery. 1987;102(4):704-710. PMID: 3660243.
6. Paes RA, Hyde I, Griffiths DM. The management of intussusception. Br J Radiol. 1988 March; 61 (723):187-189
7. Gluckman S, Karpelowsky J, Webster AC, McGee RG. Management for intussusception in children. Cochrane Database Syst Rev. 2017;6(6)
8. Efrati Y, Klin B, Kozer E, Abu-Kishk I. The role of dexamethasone in decreasing early recurrence of acute intussusception in children: A retrospective study. J Pediatr Surg. 2017;52(7):1141-1143. doi: 10.1016/j.jpedsurg.2016.12.020
9. Lin SL, Kong MS, Houng DS. Decreasing early recurrence rate of acute intussusception by the use of dexamethasone. Eur J Pediatr. 2000;159(7):551-552. doi:10.1007/s004310051336
10. Shteyer E, Koplewitz BZ, Gross E, Granot E. Medical treatment of recurrent intussusception associated with intestinal lymphoid hyperplasia. Pediatrics. 2003;111(3):682-685. doi:10.1542/peds.111.3.682
11. Akbulut S. Intussusception due to inflammatory fibroid polyp: a case report and comprehensive literature review. World J Gastroenterol. 2012;18(40):5745-5752. doi:10.3748/wjg.v18.i40.5745
12. Essa AE, Eltayeb AA, Mansour E. Evaluation of the role of Dexamethasone in decreasing early recurrence of intussusception: Using ultrasound-guided saline enema for reduction. Surgical practice. 2011. 15(4).114-119. doi.org/10.1111/j.1744-1633.2011.00560.x
13. Lopez R, Beasley SW, Blakelock R, et al. The role of steroids in children with multiple recurrences of intussusception. J Paediatr Child Health. 2012;48(2):180-181. doi:10.1111/j.1440-1754.2011.02406.x
14. Niramis R, Watanatittan S, Kruatrachue A, et al. Management of recurrent intussusception: nonoperative or operative reduction?. J Pediatr Surg. 2010;45(11):2175-2180. doi: 10.1016/j.jpedsurg.2010.07.029
15. Marsicovetere P, Ivatury SJ, White B, Holubar SD. Intestinal Intussusception: Etiology, Diagnosis, and Treatment. Clin Colon Rectal Surg. 2017;30(1):30-39. doi:10.1055/s-0036-1593429
16. Zoorob RJ, Cender D. A different look at corticosteroids. Am Fam Physician. 1998;58(2):443-450. PMID: 9713398
17. Ravitch MM, McCune RM Jr. Reduction of Intussusception by Barium Enema: A Clinical and Experimental Study. Ann Surg. 1948;128(5):904-917. doi:10.1097/00000658-194811000-00003
18. Coutinho AE, Chapman KE. The anti-inflammatory and immunosuppressive effects of glucocorticoids, recent developments and mechanistic insights. Mol Cell Endocrinol. 2011;335(1):2-13. doi: 10.1016/j.mce.2010.04.005
19. Long B, April MD. What Measures Improve Reduction of Intussusception in Pediatric Patients?. Ann Emerg Med. 2018;71(2):236-238. doi: 10.1016/j.annemergmed.2017.08.050.