Improvements to a Novel Device Simulating Pneumatic Intussusception Reduction


Objectives: Intussusception, an uncommon but important cause of acute abdomen during infancy and early childhood, can be safely and effectively treated by fluoroscopic air reduction. Although pediatric radiology fellows report ample opportunity to practice intussusception reduction, radiology residents report few opportunities to participate in this procedure. Adequate training to reduce intussusception is essential, as successful reduction obviates the need for surgery. A teaching device that simulates intussusception reduction could help radiology residents develop the skills necessary to perform this procedure. Materials and Methods: We report on improvements made to a training device developed in 2010 by Stein-Wexler et al. Since then we have simplified the manufacturing process, added several unique patient cases, improved the software so that adding patient scenarios is easier, and improved the graphic interface to make the simulation more realistic and facilitate feedback. Results: The simulator is now a customizable and robust standalone package. A thorough instructor’s manual and improvements to the graphic design-such as embedded checklists, built-in feedback mechanisms, and a more intuitive interface-make the simulator easier to use. Conclusion: We have improved our previously-reported teaching device for intussusception reduction and produced a robust simulator. We plan to make this device available to programs that train physicians in pneumatic intussusception reduction.

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S. Soosman, J. Li, G. Roper, A. Wexler, R. Stein-Wexler and T. Sanchez, "Improvements to a Novel Device Simulating Pneumatic Intussusception Reduction," Open Journal of Radiology, Vol. 3 No. 2, 2013, pp. 73-77. doi: 10.4236/ojrad.2013.32011.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] J. Bruce, Y. S. Huh, D. R. Cooney, M. P. Karp, J. E. Allen and T. C. Jewett Jr., “Intussusception: Evolution of Current Management,” Journal of Pediatric Gastroenterology and Nutrition, Vol. 6, No. 5, 1987, pp. 663-674. doi:10.1097/00005176-198709000-00003
[2] M. B. Rennels, U. D. Parashar, R. C. Holman, C. T. Le, H. G. Chang and R. I. Glass, “Lack of an Apparent Association between Intussusception and Wild or Vaccine Rotavirus Infection,” Pediatric Infectious Disease Journal, Vol. 17, No. 10, 1998, pp. 924-925. doi:10.1097/00006454-199810000-00018
[3] S. W. Beasley and N. A. Myers, “Intussusception: Current Views,” Pediatric Surgery International. Vol. 14, No. 3, 1998, p.157. doi:10.1007/s003830050473
[4] A. Danerman, D. J. Alton, S. Ein, D. Wesson, R. Superina and P. Thorner, “Perforation during Attempted Intussusception Reduction in Children—A Comparison of Perforation with Barium and Air,” Pediatric Radiology, Vol. 25, No. 2, 1995, pp. 81-88. doi:10.1007/BF02010311
[5] C. Bateni, R. Stein-Wexler, S. L. Wootton-Gorges and C. S. Li, “Radiology Residents’ Experience with Intussusception Reduction,” Pediatric Radiology, Vol. 41, No. 6, 2011, pp. 21-26. doi:10.1007/s00247-010-1923-0
[6] R. Stein-Wexler, C. Bateni, S. L. Wootton-Gorges, C. S. Li, “Pediatric Radiology Fellows’ Experience with intussusception Reduction,” Pediatric Radiology, Vol. 41, No. 11, 2011, pp. 1365-1368. doi:10.1007/s00247-011-2095-2
[7] J. S. Meyer, B. C. Dangman, C. Buonomo and J. A. Berlin, “Air and Liquid Contrast Agents in the Management of Intussusception: A Controlled, Randomized Trial,” Radiology, Vol. 188, No. 2, 1993, pp. 507-511.
[8] R. Stein-Wexler, T. Sanchez, G. E. Roper, et al., “An Interactive Teaching Device Simulating Intussusception Reduction,” Pediatric Radiology, Vol. 40, No. 11, 2010, pp. 1810-1815. doi:10.1007/s00247-010-1764-x
[9] V. G. McDermott, “Childhood Intussusception and Approaches to Treatment: A Historical Review,” Pediatric Radiology, Vol. 24, No. 3, 1994, pp. 153-155. doi:10.1007/BF02012174
[10] M. M. Ravitch and C. R. McCune, “Reduction of Intussusception by Hydrostatic Pressure; An Experimental Study,” Bulletin of the Johns Hopkins Hospital, Vol. 82, No. 5, 1948, pp. 550-568.
[11] T. W. Riebel, R. Nasir and K. Weber, “US-Guided Hydrostatic Reduction of Intussusception in Children,” Radiology, Vol. 188, No. 2, 1993, pp. 513-516.
[12] G. D. Wang and S. J. Liu, “Enema Reduction of Intussusception by Hydrostatic Pressue under Ultrasound Guidance: A Report of 377 Cases,” Journal of Pedatric Surgery, Vol. 23, No. 9, 1988, pp. 814-818. doi:10.1016/S0022-3468(88)80229-X
[13] P. Schmit, W. K. Rohrschneider and D. Christmann, “Intestinal Intussusception Survey about Diagnostic and Nonsurgical Therapeutic Procedures,” Pediatric Radiology, Vol. 29, No. 10, 1999, pp. 752-761. doi:10.1007/s002470050689
[14] T. Schmitz-Rode, C. Müller-Leisse and G. Alzen, “Comparative Examination of Various Rectal Tubes and Contrast Media for the Reduction of Intussusceptions,” Pediatric Radiology, Vol. 21, No. 5, 1991, pp. 341-345. doi:10.1007/BF02011482
[15] A. Daneman and O. Navarro, “Intussusception Part 2: An Update on the Evolution of Management,” Pediatric Radiology, Vol. 34, No. 2, 2004, pp. 97-108. doi:10.1007/s00247-003-1082-7
[16] E. Phelan, J. F. de Campo and G. Malecky, “Comparison of Oxygen and Barium Reduction of Ileocolic Intussusception,” American Journal of Roentgenolog , Vol. 150, No. 6, 1988, pp. 1349-1352. doi:10.2214/ajr.150.6.1349
[17] J. S. Meyer, “The Current Radiologic Management of Intussusception: A Survey and Review,” Pediatric Radiology, Vol. 22, No. 5, 1992, pp. 323-325. doi:10.1007/BF02016244

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