Air enema for intussusception: is predicting the outcome important?

Area of Science:

• Pediatric Surgery
• Gastroenterology

Background:

• Intussusception is a common surgical emergency in children.
• Air enema is the preferred non-operative treatment for intussusception.
• Identifying factors influencing air enema success is crucial for clinical decision-making.

Purpose of the Study:

• To evaluate the success rate of air enema for intussusception in children.
• To identify clinical factors affecting the outcome of air enema.
• To determine if predicting air enema outcomes is necessary.

Main Methods:

• Retrospective review of 179 children undergoing air enema for intussusception over 5 years.
• Analysis of clinical features including abdominal colic, vomiting, rectal bleeding, and duration of symptoms.
• Statistical analysis (chi-squared test, logistic regression) to assess the impact of clinical factors on success rates.

Main Results:

• Air enema achieved an 89% success rate with a 0.6% perforation rate.
• Reduced success was observed with rectal bleeding, rectal prolapse, dehydration, and small bowel obstruction (P < 0.05).
• Logistic regression identified prolapsing rectal intussusception (57%) and small bowel obstruction (52%) as significant predictors of reduced success.

Conclusions:

• Air enema is a safe and effective treatment for childhood intussusception, with a high success rate.
• Predicting outcomes is not critical due to the high success rate and low complication rate.
• Air enema should be attempted in all cases except those with peritonitis.