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     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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LETTERS TO THE EDITOR
Year : 2022  |  Volume : 27  |  Issue : 6  |  Page : 788-789
 

LoVE for children with intussusceptions and related innovations


Visiting Paediatric Surgeon, Park Medical Research and Welfare Society, Kolkata, West Bengal, India

Date of Submission31-May-2022
Date of Decision04-Jul-2022
Date of Acceptance21-Aug-2022
Date of Web Publication11-Nov-2022

Correspondence Address:
Uday Sankar Chatterjee
Park Medical Research and Welfare Society, Residence: 356/3 S.K. Bose Sarani, Kolkata 700 030, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaps.jiaps_78_22

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How to cite this article:
Chatterjee US. LoVE for children with intussusceptions and related innovations. J Indian Assoc Pediatr Surg 2022;27:788-9

How to cite this URL:
Chatterjee US. LoVE for children with intussusceptions and related innovations. J Indian Assoc Pediatr Surg [serial online] 2022 [cited 2022 Nov 30];27:788-9. Available from: https://www.jiaps.com/text.asp?2022/27/6/788/360973




Sir,

Thanks to Rai et al.[1] for their recent innovation for reduction of intussusceptions in a further comfortable way. Love and compassion are essential for innovations. We have witnessed various types of innovations to make the reduction of intussusceptions safe, easy, and less traumatic. Through innovations, management of intussusceptions has progressed toward minimally invasive reduction, for example, with contrast enema (fluoroscopic), with combinations of normal saline and ultrasonography, and even with simple stethoscopes and air.[2] Along with, surgical procedures, innovative laparoscopic,[3] and open surgery supplemented with a hydrostatic reduction[4] are also showing a reduced chance of resection anastomoses.

Nonetheless, at the subdivisional level and sometimes in urban setup, fluoroscopy and ultrasonologist might not available on weekends, holidays, or at night time.[4] Hence, the issue is: how could we offer any innovative procedure at the subdivisional level to avoid delay in the management of intussusceptions and prevention of complications and referral to tertiary centers.

Recently another innovative procedure is suggested[5] with Low Volume Enema (LoVE) for the reduction of intussusceptions in the Journal of Paediatric Surgery (JPS). In all the above mentioned innovative procedures,[1],[2],[3],[4] hydrostatic or pneumatic pressure is delivered from external appliances. Hence, it necessitates radiologist or ultrasonologist to be available to monitor the reduction. However, in LoVE, normal saline is infused into the rectum without additional pressure. Necessary hydrostatic pressure is generated intrinsically by intraluminal pressure of healthy colon and abdominal pressure of irritable, crying children.[5] Generated intrinsic pressure turns into hydraulic pressure in the presence of infused saline to be capable to reduce intussusceptum as per Pascal's law. The peristaltic contraction would be less efficient or would be absent in an unhealthy gut which might indirectly protect the perforation of an unhealthy gut following LoVE.[5]

Why this correspondence in JIAPS: It is an alert letter to alert the interested pediatricians and pediatric surgeons to find out an interesting and easy answer to solve the problem of intussusceptions at subdivisional level, following further case–control study on LoVE which is published in JPS. However, JPS, unlike JIAPS, is not an open-access journal. Hence, easy accessibility of JIAPS would indirectly create awareness in the academic world of pediatricians and pediatric surgeons on LoVE published in JPS.

Index article (ref. 5) was initially sent to JIAPS as correspondence; however, it could not meet the standard to be published in JIAPS. Hence, the author re-submitted that in JPS and was promptly accepted. Hence, it is a pride fact for JIAPS; for this kind of reverse acceptance indicates an uprising standard of publishing in JIAPS.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Rai S, DCunha AR, ShreeRaghu RM, DSouza N. The syringe technique for ultrasound-guided hydrostatic intussusception reduction. J Indian Assoc Pediatr Surg 2022;27:329-32.  Back to cited text no. 1
  [Full text]  
2.
Tanger R, Singh AP, Gupta AK, Barolia DK, Shukla AK. Nonavailability of ultrasound: Try stethoscope in pneumatic reduction. J Indian Assoc Pediatr Surg 2020;25:76-9.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Chandrasekharam VV, Gazula S, Gorthi RP. Laparoscopy-assisted hydrostatic in situ reduction of intussusception: A reasonable alternative? J Indian Assoc Pediatr Surg 2011;16:8-10.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Chatterjee US, Ghosh A, Basu AK, Mukhopadhyay PP. Intraoperative hydrostatic reduction of intussusception. J Indian Assoc Pediatr Surg 2008;13:107-8.  Back to cited text no. 4
[PUBMED]  [Full text]  
5.
Chatterjee US. Reduction of intussusceptions with low volume enema. J Pediatr Surg 2022; 57: 752. doi; 10.1016/j.jpedsurg.2022.05.002.  Back to cited text no. 5
    




 

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