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Small bowel intussusceptions: issues and controversies related to pneumatic reduction and surgical approach

A K Saxena1, U Seebacher, C Bernhardt

  • 1Department of Pediatric Surgery, Medical University of Graz, Graz, Austria. amulya.saxena@meduni-graz.at

Acta Paediatrica (Oslo, Norway : 1992)
|September 25, 2007
PubMed

Insights

Small bowel intussusceptions (SBI) are uncommon in children. Pneumatic reduction is effective for viable ileoileal intussusceptions, but caution is advised for jejunojejunal cases or those with lead points, prioritizing early diagnosis for better outcomes.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Radiology

Background:

  • Small bowel intussusception (SBI) is a rare condition in the pediatric population.
  • Understanding its incidence, presentation, and management is crucial for optimal patient outcomes.

Purpose of the Study:

  • To determine the incidence, clinical presentation, management, and outcomes of pediatric small bowel intussusceptions (SBI).
  • To evaluate the effectiveness of different management strategies, including pneumatic reduction and surgical intervention.

Main Methods:

  • Retrospective review of hospital charts for pediatric patients diagnosed with SBI between 1999 and 2006.
  • Data collection included clinical presentation, diagnostic imaging, management strategies, and patient outcomes.

Main Results:

  • Out of 111 intussusception cases, 28 (25.2%) were identified as SBI.
  • Spontaneous reduction occurred in 18 of 28 SBI patients; 10 required intervention.
  • Pneumatic reduction was successful in 6 of 7 ileoileal cases, while 3 patients required surgical resection.

Conclusions:

  • Pneumatic reduction is a viable option for ileoileal intussusceptions with preserved bowel viability.
  • Caution is recommended for jejunojejunal or ileoileal SBI with lead points or ischemia.
  • Accurate ultrasound interpretation and timely intervention, surgical or non-surgical, minimize morbidity. Early diagnosis improves outcomes with non-surgical methods.
Abstract

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