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The changing face of intussusception

D M Hays1, J L Gwinn

  • 1Departments of Surgery and Radiology, Children's Hospital of Los Angeles, USA.

JAMA
|March 7, 1966
PubMed

Insights

Hydrostatic pressure reduction successfully treats most early intussusception cases in infants. However, it does not decrease the rate of bowel infarction requiring surgery, highlighting the need for prompt medical intervention.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Medical Imaging

Background:

  • Intussusception is a common surgical emergency in infants.
  • Historically, surgical reduction was the primary treatment.
  • Evolving management strategies aim to improve outcomes.

Purpose of the Study:

  • To analyze trends in pediatric intussusception management over 26 years.
  • To evaluate the efficacy of hydrostatic pressure reduction versus surgery.
  • To assess the impact of management strategies on resection rates and outcomes.

Main Methods:

  • Retrospective analysis of pediatric intussusception cases over 26 years.
  • Comparison of outcomes between hydrostatic pressure reduction and surgical intervention.
  • Review of resection rates and pathological findings.

Main Results:

  • Hydrostatic pressure reduction is now the standard for early/subacute intussusception.
  • Emergency laparotomy is reserved for critically ill patients or those with obstruction.
  • Resection rates remain significant (16.4%) in surgical cases, primarily due to infarction.
  • Surgical advances have reduced mortality associated with resection.

Conclusions:

  • Hydrostatic pressure reduction is effective but does not prevent bowel infarction.
  • Prompt diagnosis and treatment are crucial; non-hospital management poses risks.
  • Surgical management has improved, but infarction remains a concern in severe cases.

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