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1.
Pediatr Surg Int ; 40(1): 148, 2024 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-38825635

RESUMO

BACKGROUND: Peutz-Jeghers syndrome (PJS) is an autosomal dominant disorder characterized by hamartomatous gastrointestinal polyps along with the characteristic mucocutaneous freckling. Multiple surgeries for recurrent intussusception in these children may lead to short bowel syndrome. Here we present our experience of management in such patients. METHODS: From January 2015 to December 2023, we reviewed children of PJS, presented with recurrent intussusceptions. Data were collected regarding presentation, management, and follow-up with attention on management dilemma. Diagnosis of PJS was based on criteria laid by World Health Organization (WHO). RESULTS: A total of nine patients were presented with age ranging from 4 to 17 years (median 9 years). A total of eighteen laparotomies were performed (7 outside, 11 at our centre). Among 11 laparotomies done at our centre, resection and anastomosis of bowel was done 3 times while 8 times enterotomy and polypectomy was done after reduction of intussusception. Upper and lower gastrointestinal endoscopy (UGIE & LGIE) was done in all cases while intraoperative enteroscopy (IOE) performed when required. Follow-up ranged from 2 months to 7 years. CONCLUSION: Children with PJS have a high risk of multiple laparotomies due to polyps' complications. Considering the diffuse involvement of the gut, early decision of surgery and extensive bowel resection should not be done. Conservative treatment must be tried under close observation whenever there is surgical dilemma. The treatment should be directed in the form of limited resection or polypectomy after reduction of intussusception.


Assuntos
Intussuscepção , Síndrome de Peutz-Jeghers , Recidiva , Humanos , Síndrome de Peutz-Jeghers/complicações , Síndrome de Peutz-Jeghers/cirurgia , Intussuscepção/cirurgia , Intussuscepção/terapia , Criança , Pré-Escolar , Adolescente , Feminino , Masculino , Estudos Retrospectivos , Laparotomia/métodos , Seguimentos
7.
BMC Gastroenterol ; 24(1): 180, 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38778288

RESUMO

BACKGROUND: Intussusception presents a significant emergency that often necessitates bowel resection, leading to severe complications and management challenges. This study aims to investigate and establish a scoring system to enhance the prediction of bowel resection necessity in pediatric intussusception patients. METHODS: This retrospective study analyzed 660 hospitalized patients with intussusception who underwent surgical management at a pediatric hospital in Southwest China from April 2008 to December 2020. The necessity of bowel resection was assessed and categorized in this cohort. Variables associated with bowel resection were examined using univariate and multivariate logistic regression analyses. Based on these analyses, a scoring system was developed, grounded on the summation of the coefficients (ß). RESULTS: Among the 660 patients meeting the inclusion criteria, 218 required bowel resection during surgery. Bowel resection occurrence was linked to an extended duration of symptoms (Odds Ratio [OR] = 2.14; 95% Confidence Interval [CI], 1.03-5.23; P = 0.0015), the presence of gross bloody stool (OR = 8.98; 95% CI, 1.76-48.75, P < 0.001), elevated C-reactive protein levels (OR = 4.79; 95% CI, 1.12-28.31, P = 0.0072), lactate clearance rate (LCR) (OR = 17.25; 95% CI, 2.36-80.35; P < 0.001), and the intussusception location (OR = 12.65; 95% CI, 1.46-62.67, P < 0.001), as determined by multivariate logistic regression analysis. A scoring system (totaling 14.02 points) was developed from the cumulative ß coefficients, with a threshold of 5.22 effectively differentiating infants requiring surgical intervention from others with necrotizing enterocolitis (NEC), exhibiting a sensitivity of 78.3% and a specificity of 71.9%. CONCLUSIONS: This study successfully identified multiple risk factors for bowel resection and effectively used a scoring system to identify patients for optimal clinical management.


Assuntos
Intussuscepção , Humanos , Intussuscepção/cirurgia , Intussuscepção/diagnóstico , Estudos Retrospectivos , Masculino , Feminino , Lactente , Pré-Escolar , China , Proteína C-Reativa/análise , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Modelos Logísticos , Criança , Fatores de Risco
8.
J Int Med Res ; 52(4): 3000605241240995, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38663880

RESUMO

Intussusception is defined as the invagination of a proximal segment of the bowel into the adjoining or distal segment. In most adults with intussusception, there is a demonstrable lead point with a definite pathologic abnormality. The clinical features of intussusception include chronic intermittent abdominal pain, nausea and vomiting, constipation, and a palpable abdominal mass. The present case report describes a 62-year-old woman with a 2-week history of abdominal pain and 9-day history of vomiting. Clinical, imaging, and histologic evaluations revealed a jejunojejunal intussusception with a gastrointestinal stromal tumor as the lead point. A gastrointestinal stromal tumor should be considered as a possible lead point in adult patients with intussusception. The implication of reducing the intussusception prior to tumor resection requires further evaluation in view of the risk of venous embolism, including direct spread of malignant cells, in cases involving a large polypoid mass with a necrotic surface that extends to the serosa as shown by intraoperative examination. Accordingly, the rationale for adjuvant therapy with imatinib also requires further evaluation.


Assuntos
Tumores do Estroma Gastrointestinal , Intussuscepção , Humanos , Intussuscepção/etiologia , Intussuscepção/cirurgia , Intussuscepção/diagnóstico , Intussuscepção/patologia , Intussuscepção/diagnóstico por imagem , Feminino , Tumores do Estroma Gastrointestinal/complicações , Tumores do Estroma Gastrointestinal/patologia , Tumores do Estroma Gastrointestinal/cirurgia , Tumores do Estroma Gastrointestinal/diagnóstico , Pessoa de Meia-Idade , Doenças do Jejuno/etiologia , Doenças do Jejuno/cirurgia , Doenças do Jejuno/diagnóstico , Doenças do Jejuno/patologia , Tomografia Computadorizada por Raios X , Dor Abdominal/etiologia
9.
Magy Seb ; 77(1): 33-38, 2024 Apr 02.
Artigo em Húngaro | MEDLINE | ID: mdl-38564272

RESUMO

A felnottkori invaginatiók ritkák, klinikai megjelenésük eltér a gyerekkori formáktól. Klinikumuk igen változatos, gyakran atípusos, jellemzo, hogy egy klinikai sejtés nyomán gondolni kell az invaginatio lehetoségére. A kiegészíto vizsgálatok közül kiemelkedo szerep jut a computer tomográfiának (CT), ami magas érzékenységgel és fajlagossággal képes kimutatni a béltraktus invaginatióját. Gyógyításuk az esetek legnagyobb részében sebészi, sokszor csak a mutét során lehetséges felismerni a kiváltó okot. Esetismertetésünkben egy rendkívül ritka, felnottkori, passage-zavart okozó colo-colicus, a bal colonfelet érinto, a colon-flexura lienalis-descendens határra lokalizált invaginatio klinikai jellemzoit, diagnosztikáját és definitív megoldásaként a laparoscoposan asszisztált bal oldali haemicolectomia mutéti megoldását mutatjuk be. Munkánkban összefoglaljuk a felnottkori invaginatiókra vonatkozó kórélettani fogalmakat, diagnosztikai lehetoségeket, a leggyakoribb kiváltó tényezoket és terápiás lehetoségeket.


Assuntos
Citrus , Intussuscepção , Adulto , Humanos , Colo , Colo Descendente
10.
Acute Med ; 23(1): 43-45, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38619169

RESUMO

This case report describes an atypical small bowel obstruction in a 71- years old cannabis user and how point-of-care of ultrasound (PoCUS) helped to its management by further orientating the physician toward the bowel obstruction etiology, namely intussusception. Intussusception is the invagination of an intestinal segment into the adjacent segment. The acute clinical presentation of intussusception often has non-specific symptoms, and the diagnosis can be challenging. While the most common etiology is neoplasm, intussusception also occurs in bowel motility disorder such as after cannabis use. Although this case report illustrates intussusception PoCUS findings, these should nevertheless be integrated into the clinical picture and CT-scan should remain the gold standard complementary examination in case of a suspected bowel obstruction.


Assuntos
Cannabis , Intussuscepção , Médicos , Humanos , Idoso , Intussuscepção/diagnóstico por imagem , Intussuscepção/etiologia , Sistemas Automatizados de Assistência Junto ao Leito , Testes Imediatos
11.
S Afr J Surg ; 62(1): 86-88, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38568133

RESUMO

SUMMARY: Adult intussusception is rare, and its non-specific symptoms make the diagnosis particularly difficult. Imaging modalities such as X-ray, abdominal ultrasound and multidetector computed tomography (MDCT) may improve preoperative detection. In this report, we present a 53-year-old male with an ileocaecal intussusception. The patient underwent an extended right hemicolectomy and double barrel ileocolostomy. Histopathological review of the specimen identified the lead point as an intramural caecal lymph node which, as far as we are aware, is the first time this type of lead point has been reported.


Assuntos
Intussuscepção , Humanos , Masculino , Pessoa de Meia-Idade , Anastomose Cirúrgica , Colectomia , Intussuscepção/diagnóstico por imagem , Intussuscepção/etiologia , Linfonodos
12.
Medicine (Baltimore) ; 103(15): e37772, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38608117

RESUMO

RATIONALE: Retrograde jejunoduodenogastric intussusception refers to invagination of distal small intestine into the stomach. It is extremely rare. It is often associated with displaced feeding catheter in which its balloon tip migrates past the gastric pylorus. The intussusception is triggered by retraction of migrated catheter. It is often accompanied by feeding intolerance or catheter malfunction. This report describes a distinctive case of retrograde jejunoduodenogastric intussusception associated with a fully functioning nonballoon nasojejunal tube. PATIENT CONCERN: A 19-year-old female was presented with repeated vomiting and abdominal distension for 5 days. DIAGNOSIS: An abdominal computerized tomography revealed retrograde jejunoduodenogastric intussusception causing air/fluid-filled gastric distension. Immediate endoscopic examination revealed a loop of small intestine, protruding through the pylorus. Progressed ischemia of the migrated small bowel loop was confirmed. INTERVENTIONS: At laparotomy, a jejunal loop migrating into the duodenum and stomach at the level of the ligament of Treitz was noticed. After manual reduction of migrated bowel, 2 segmental resections of necrotic segment were performed. A feeding jejunostomy was constructed in the proximal jejunum. OUTCOMES: Enteral feeding through the surgically constructed feeding jejunostomy was started on the 5th operative day and the patient was discharged on the 16th postoperative day. LESSONS: When a patient under tube feeding exhibits abrupt intractable gastroesophageal reflux with a sign of catheter migration, we must consider the possibility of catheter-related intussusception. Having a fully functioning feeding catheter with nonballoon tip does not preclude retrograde jejunoduodenogastric intussusception.


Assuntos
Refluxo Gastroesofágico , Intussuscepção , Feminino , Humanos , Recém-Nascido , Adulto Jovem , Adulto , Intussuscepção/etiologia , Intussuscepção/cirurgia , Catéteres/efeitos adversos , Estômago , Vômito
13.
BMC Pediatr ; 24(1): 227, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38561715

RESUMO

BACKGROUND: Summarizing the clinical features of children with intussusception secondary to small bowel tumours and enhancing awareness of the disease. METHODS: Retrospective summary of children with intussusception admitted to our emergency department from January 2016 to January 2022, who underwent surgery and were diagnosed with small bowel tumours. Summarize the types of tumours, clinical presentation, treatment, and prognosis. RESULTS: Thirty-one patients were included in our study, 24 males and 7 females, with an age of onset ranging from 1 m to 11y 5 m. Post-operative pathology revealed 4 types of small intestinal tumour, 17 lymphomas, 10 adenomas, 4 inflammatory myofibroblastomas and 1 lipoma. The majority of tumours in the small bowel occur in the ileum (83.9%, 26/31). Abdominal pain, vomiting and bloody stools were the most common clinical signs. Operative findings indicated that the small bowel (54.8%, 17/31) and ileocolic gut were the main sites of intussusception. Two types of procedure were applied: segmental bowel resection (28 cases) and wedge resection of mass in bowel wall (3 cases). All patients recovered well postoperatively, with no surgical complications observed. However, the primary diseases leading to intussusception showed slight differences in long-term prognosis due to variations in tumor types. CONCLUSIONS: Lymphoma is the most common cause of intussusception in pediatric patients with small bowel tumours, followed by adenoma. Small bowel tumours in children tend to occur in the ileum. Therefore, the treatment of SBT patients not only requires surgeons to address symptoms through surgery and obtain tissue samples but also relies heavily on the expertise of pathologists for accurate diagnosis. This has a significant impact on the overall prognosis of these patients.


Assuntos
Neoplasias Intestinais , Intussuscepção , Masculino , Feminino , Humanos , Criança , Intussuscepção/etiologia , Intussuscepção/cirurgia , Estudos Retrospectivos , Neoplasias Intestinais/complicações , Neoplasias Intestinais/cirurgia , Dor Abdominal/complicações , Intestino Delgado/cirurgia
15.
BMJ Case Rep ; 17(4)2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38663897

RESUMO

A colonic lipoma is an uncommon lesion that is linked with clinical symptoms in only a small portion of patients. Patients with large lipomas are often referred for major surgery, which is associated with significant morbidity and mortality. In this case, we described a female patient with recurrent episodes of gastrointestinal blood loss, abdominal pain and colocolic intussusceptions due to a large, lumen-filling, obstructive lipoma in the splenic flexure. On abdominal CT, a lesion of 3.6 cm was visualised with a fat-like density without solid components. Considering its benign nature, we intended to preserve the colon by deroofing the upper part of the lesion and then performing a colonoscopy-assisted laparoscopic wedge resection. During reassessment, auto-amputation of part of the lesion was observed, most likely as a result of long-lasting mechanical effects, which made it possible to perform solely a wedge resection with an excellent outcome.


Assuntos
Neoplasias do Colo , Colonoscopia , Laparoscopia , Lipoma , Humanos , Lipoma/cirurgia , Lipoma/diagnóstico por imagem , Feminino , Neoplasias do Colo/cirurgia , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/diagnóstico por imagem , Laparoscopia/métodos , Colonoscopia/métodos , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Dor Abdominal/etiologia , Intussuscepção/cirurgia , Intussuscepção/diagnóstico por imagem , Intussuscepção/diagnóstico , Resultado do Tratamento
16.
Clin J Gastroenterol ; 17(3): 466-471, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38504057

RESUMO

Adult-onset intussusception, particularly associated with colonoscopy, is extremely rare. A 78-year-old man, referred to our hospital for colonic endoscopic mucosal resection (EMR), experienced subsequent dull abdominal pain, as well as elevated peripheral blood leukocytosis and C-reactive protein levels. Abdominal computed tomography (CT) revealed a colocolonic intussusception at the hepatic flexure. Emergency colonoscopy revealed ball-like swollen mucosa distal to the EMR site of the ascending colon. The mucosa was intact without necrosis. The endoscopic approach was able to temporarily release the intussusception. A transanal drainage tube was inserted through the endoscope to prevent relapse. Both CT and colonoscopy showed release of the intussusception. Our case underscores the importance of considering colocolonic intussusception in post-colonoscopy abdominal pain, advocating for endoscopic management after excluding mucosal necrosis.


Assuntos
Doenças do Colo , Ressecção Endoscópica de Mucosa , Intussuscepção , Humanos , Idoso , Masculino , Intussuscepção/cirurgia , Intussuscepção/etiologia , Intussuscepção/diagnóstico por imagem , Ressecção Endoscópica de Mucosa/efeitos adversos , Ressecção Endoscópica de Mucosa/métodos , Doenças do Colo/cirurgia , Doenças do Colo/etiologia , Colonoscopia/métodos , Tomografia Computadorizada por Raios X , Mucosa Intestinal/cirurgia , Complicações Pós-Operatórias/cirurgia , Complicações Pós-Operatórias/etiologia
17.
Cir Cir ; 92(1): 120-123, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38537228

RESUMO

The gold standard for bariatric surgery is the laparoscopic gastric bypass, which consists in forming a small gastric pouch and a Roux-en-Y anastomosis. We present the case of a 41-year-old female who underwent a laparoscopic gastric bypass 8 years prior to her admission to the emergency room, where she arrived complaining of severe and colicky epigastric abdominal pain. The abdominal computed tomography showed a jejuno-jejunal intussusception, for which the patient underwent urgent exploratory laparotomy with intussusception reduction. Intestinal intussusception is a possible postoperative complication of a Roux-en-Y gastric bypass.


El Método de referencia en la cirugía bariátrica es el bypass gástrico laparoscópico, que consiste en la creación de una bolsa gástrica pequeña, anastomosada al tracto digestivo mediante una Y de Roux. Presentamos el caso de una mujer de 41 años con el antecedente de un bypass gástrico laparoscópico realizado 8 años antes, quien ingresó al servicio de urgencias refiriendo dolor abdominal grave. La tomografía computarizada abdominal evidenció una intususcepción a nivel de la anastomosis yeyuno-yeyuno, por lo que se realizó una laparotomía exploradora con reducción de la intususcepción. Se debe considerar la intususcepción intestinal como complicación posoperatoria de bypass gástrico.


Assuntos
Derivação Gástrica , Intussuscepção , Doenças do Jejuno , Laparoscopia , Obesidade Mórbida , Humanos , Feminino , Adulto , Derivação Gástrica/efeitos adversos , Derivação Gástrica/métodos , Intussuscepção/diagnóstico por imagem , Intussuscepção/etiologia , Intussuscepção/cirurgia , Laparoscopia/métodos , Doenças do Jejuno/diagnóstico por imagem , Doenças do Jejuno/etiologia , Doenças do Jejuno/cirurgia , Anastomose em-Y de Roux/efeitos adversos , Dor Abdominal/etiologia , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Obesidade Mórbida/cirurgia , Obesidade Mórbida/complicações
18.
PLoS One ; 19(3): e0297985, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38498581

RESUMO

OBJECTIVES: We conducted a comprehensive meta-analysis to compare the effectiveness and safety of fluoroscopy-guided air enema reduction (FGAR) and ultrasound-guided hydrostatic enema reduction (UGHR) for the treatment of intussusception in pediatric patients. METHODS: A systematic review and meta-analysis were conducted on retrospective studies obtained from various databases, including PUBMED, MEDLINE, Cochrane, Google Scholar, China National Knowledge Infrastructure (CNKI), WanFang, and VIP Database. The search included publications from January 1, 2003, to March 31, 2023, with the last search done on Jan 15, 2023. RESULTS: We included 49 randomized controlled studies and retrospective cohort studies involving a total of 9,391 patients, with 4,841 in the UGHR and 4,550 in the FGAR. Specifically, UGHR exhibited a significantly shorter time to reduction (WMD = -4.183, 95% CI = (-5.402, -2.964), P < 0.001), a higher rate of successful reduction (RR = 1.128, 95% CI = (1.099, 1.157), P < 0.001), and a reduced length of hospital stay (WMD = -1.215, 95% CI = (-1.58, -0.85), P < 0.001). Furthermore, UGHR repositioning was associated with a diminished overall complication rate (RR = 0.296, 95% CI = (0.225, 0.389), P < 0.001) and a lowered incidence of perforation (RR = 0.405, 95% CI = (0.244, 0.670), P < 0.001). CONCLUSION: UGHR offers the benefits of being non-radioactive, achieving a shorter reduction time, demonstrating a higher success rate in repositioning in particular, resulting in a reduced length of postoperative hospital stay, and yielding a lower overall incidence of postoperative complications, including a reduced risk of associated perforations.


Assuntos
Intussuscepção , Criança , Humanos , Enema/métodos , Fluoroscopia , Intussuscepção/terapia , Estudos Retrospectivos , Ultrassonografia
19.
J Int Med Res ; 52(3): 3000605241233525, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38518196

RESUMO

OBJECTIVE: To assess the pattern of clinical presentations and factors associated with the management outcome of pediatric intussusception among children treated at Wolaita Sodo University Comprehensive Specialized Hospital, Ethiopia. METHODS: This retrospective cross-sectional study included the medical records of 103 children treated for intussusception from 2018 to 2020. The data collected were analyzed using SPSS 25.0 (IBM Corp., Armonk, NY, USA). RESULTS: In total, 84 (81.6%) patients were released with a favorable outcome. Ileocolic intussusception was a positive predictor, with a nine-fold higher likelihood of a favorable outcome than other types of intussusception [adjusted odds ratio (AOR), 9.16; 95% confidence interval (CI), 2.39-21.2]. Additionally, a favorable outcome was three times more likely in patients who did than did not undergo manual reduction (AOR, 3.08; 95% CI, 3.05-5.48). Patients aged <1 year were 96% less likely to have a positive outcome than those aged >4 years (AOR, 0.04; 95% CI, 0.03-0.57). CONCLUSION: Most patients were discharged with favorable outcomes. Having ileocolic intussusception and undergoing manual reduction were associated with significantly more favorable outcomes of pediatric intussusception. Therefore, nonsurgical management such as hydrostatic enema and pneumatic reduction is recommended to reduce hospital discharge of patients with unfavorable outcomes.


Assuntos
Doenças do Íleo , Intussuscepção , Criança , Humanos , Lactente , Estudos Transversais , Intussuscepção/terapia , Intussuscepção/cirurgia , Estudos Retrospectivos , Universidades , Doenças do Íleo/cirurgia , Enema , Hospitais , Resultado do Tratamento
20.
CJEM ; 26(4): 235-243, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38538954

RESUMO

OBJECTIVES: As point-of-care ultrasound (POCUS) has emerged as a valuable tool for intussusception screening, this quality improvement study aimed to implement a "POCUS-first" pathway in a Pediatric Emergency Department (ED) to streamline workflow and expedite care for children with suspected intussusception. METHODS: This was a prospective analysis of children diagnosed with ileocolic intussusception in a Pediatric ED between June 2022 and June 2023. The study compared the "POCUS-first" cohort with the group receiving only radiology-performed ultrasound. Key outcomes included physician initial assessment to radiology-performed US time and physician initial assessment to reduction time. Continuous improvement efforts incorporated pediatric emergency medicine physician training, education, and pathway dissemination through plan-do-study-act cycles. RESULTS: The study included 29 patients in the "POCUS-first" pathway group and 70 patients in the non-POCUS group. The "POCUS-first" pathway demonstrated a significantly shorter physician initial assessment to reduction time compared to the non-POCUS group (170.7 min vs. 240.6 min, p = 0.02). Among non-transferred patients, the "POCUS-first" group also had a significantly shorter emergency department length of stay (386 min vs. 544 min, p = 0.047). CONCLUSIONS: Implementation of a "POCUS-first" pathway for managing ileocolic intussusception led to notable improvements in process efficiency. The shorter physician initial assessment to reduction time highlights the potential for expedited decision-making and intervention. These study findings support the potential of this pathway to optimize the management and outcomes of children with ileocolic intussusception.


RéSUMé: OBJECTIFS: Comme l'échographie au point de soin (POCUS) est devenue un outil précieux pour le dépistage de l'intussusception, cette étude d'amélioration de la qualité visait à mettre en œuvre une voie "POCUS-first" dans un service d'urgence pédiatrique (ED) rationaliser le flux de travail et accélérer les soins aux enfants présentant une intussusception suspectée. MéTHODES: Il s'agissait d'une analyse prospective des enfants diagnostiqués avec une intussusception iléo-colique dans un DE pédiatrique entre juin 2022 et juin 2023. L'étude a comparé la cohorte "POCUS-first" avec le groupe recevant uniquement des ultrasons radiologiques. Les principaux résultats comprenaient l'évaluation initiale par le médecin du temps de radiologie effectué aux États-Unis et l'évaluation initiale par le médecin du temps de réduction. Les efforts d'amélioration continue ont incorporé la formation, l'éducation et la diffusion des parcours des médecins en médecine d'urgence pédiatrique par le biais de cycles de plan-do-study-act. RéSULTATS: L'étude a inclus 29 patients dans le groupe "POCUS-first" et 70 patients dans le groupe non-POCUS. La voie "POCUS-first" a démontré une évaluation initiale significativement plus courte du temps de réduction par rapport au groupe non POCUS (170,7 minutes vs. 240,6 minutes, p = 0,02). Parmi les patients non transférés, le groupe "POCUS-first" a également eu une durée de séjour à l'urgence significativement plus courte (386 minutes vs. 544 minutes, p = 0,047). CONCLUSIONS: La mise en œuvre d'une voie "POCUS-first" pour gérer l'intussusception iléo-colique a conduit à des améliorations notables de l'efficacité des processus. L'évaluation initiale plus courte du médecin pour réduire le temps met en évidence la possibilité d'une prise de décision et d'une intervention accélérée. Les résultats de cette étude confirment le potentiel de cette voie pour optimiser la prise en charge et les résultats des enfants atteints d'intussusception iléo-colique.


Assuntos
Intussuscepção , Sistemas Automatizados de Assistência Junto ao Leito , Criança , Humanos , Intussuscepção/diagnóstico por imagem , Intussuscepção/terapia , Testes Imediatos , Ultrassonografia , Serviço Hospitalar de Emergência
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