air enema

air enema

The administration of air per rectum, either therapeutically (e.g., to reduce into intussusception, especially in children) or diagnostically (in conjunction with a barium enema to create a so-called “double contrast” series of films, which allows assessment of the colonic mucosa for superficial lesions, such as polyps, adenomas and cancer).
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Air enema for diagnosis and reduction of intussusception: clinical experience and pressure correlates.
Routinely, in the pediatric population, an attempt is given to manual reduction with air enema. However, air enemas are generally avoided in the adult population due to the high probability of an underlying malignant process and the associated theoretical risks.
Following consultation with pediatric surgery, she emergently underwent an air enema reduction under fluoroscopy with air entry into the terminal ileum after several initial attempts and was hospitalized after the procedure for observation.
Caption: FIGURE 2: Abdominal radiograph after subsequent air enema demonstrates a "meniscus sign" of intussusception.
there is an absence of pseudoreduction, as seen with fluoroscopic-guided procedures, and there is no fluctuation in the intracolonic pressure, as seen with an air enema. The possibility of perforation is extremely low because the pressure exerted on the bowel wall is more evenly distributed with saline.
Multimodalities of management included nonoperative reduction, that is hydrostatic enema reduction in 2 cases (3.2), barium enema reduction 45 cases (72.5) and air enema reduction in 12 cases (19.3), finally 3 cases (4.8) which failed enema reduction were operated.
Modalities of management included nonoperative reduction that is hydrostatic enema reduction in 2 cases (3.2), barium enema reduction 45 cases (72.5) and air enema reduction in 12 cases (19.3), finally 3cases (4.8) which failed enema reduction were operated; 1 case (1.61) intussusception-associated death was recorded.
The authors favor the air enema for speed, decreased radiation dose, and cleanliness, reserving the contrast enema for children with a higher pretest probably of a pathologic lead point based on age (<1 month old or >4 years old).
Air enema's use has increased due to its lower perforation risk, less radiation exposure, faster and better reduction rate.
*** Then either reduction with barium, hydrostatic (lactated Ringer's) or air enema, or surgery
Possible etiologies of perforation in Western countries implicate chronic steroid administration, NSAIDs, severe underlying illness, trauma, iatrogenic perforations from EGD, and air enemas in the radiologic reduction of intussusception.