L/O/G/O

Non Operative
Management of
Intussusception

Manajemen Non operatif pada Invaginasi

menggunakan
1. Teknik Pneumatik : Udara, Oksigen
2. Teknik Hidrostatik : Barium, Air, Cairan
Kontras iodine yang larut dalam air,
NaCl 0.9%

www.themegallery.com

Kriteria pasien yang dilakukan

terapi nonoperatif
Gejala
berlangsung
kurang dari 48 jam
Tidak ada gejala
sepsis, demam
tinggi dan
dehidrasi
Tidak ada gejala
peritonitis

Tidak ada riwayat pembedahan sebelumnya

Tidak ada udara bebas dari gambaran
radiologi

www.themegallery.com

Teknik pneumatik
Pneumatik murah,
aman dan efektif
Angka
kekambuhan dan
morbiditas lebih
rendah
dibandingkan
hidrostatik

Menggunakan Balon Chateter

www.themegallery.com

Pneumatic Air Enema

Pasien dalam posisi
pronasi
Folley chateter
dimasukkan dan
balon
dikembangkan,
gluteus di rapatkan

Diberikan udara selama 5 menit dengan tekanan

120mmHg dalam 1 tindakan dan berjarak 10 menit
antara 1 tindakan dengan tindakan lain
Lakukan Observasi dengan Fluroscopy

www.themegallery.com
Pediatric surgery edition 7, Chapter 85-Intususseption

Methode Hydrostatic Barium

Enema

Patient was put on

lateral position with
sedation
The tip Of Foleys
catheter of size 16 Fr
was lubricated with
lidocaine gel and
inserted into rectum,
ballon was inlated by
injecting up to 30 ml

Chateter was connected to an intravenous fluid line and

free flow at 130 cm (3 feet) from the bed level and with
volume 500 cc

rule of threes (three

attempts, each of 3
minutes
duration and with enema
bags 3 feet above the
www.themegallery.com
table)

 The procedure was

abandoned if the
intussusceptum failed
to reduce/move after
three attempts, each
lasting about 3
minutes

The hydrostatic pressure should not exceed the

equivalen of 1mmH2O for a maximum of 10
minute

www.themegallery.com

 Gradual distention
of colon and
retrograde
movement of
intussusception
toward the caecum
were monitored by
USG or Fluroscopy

After successful reduction, the patient was admitted

to the ward and discharged only when he/she
tolerated a regular diet and had normal bowel
movement which on the average took two days

www.themegallery.com

L/O/G/O

Thank you!
www.themegallery.com