Enema-reduced intussusception management: is hospitalization necessary?
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Published on: May 16, 2025
Kathryn Herwig1, Timothy Brenkert, Joseph D Losek
1Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA.
Insights
Hospitalized children with enema-reduced intussusception generally require minimal medical intervention and have a low risk of complications. These findings suggest that outpatient management may be a suitable alternative for many cases.
Area of Science:
- Pediatric Gastroenterology
- Clinical Pediatrics
- Medical Interventions
Background:
- Intussusception is a common cause of bowel obstruction in infants and children.
- Enema reduction is a standard treatment for intussusception, but hospitalization criteria vary.
- Understanding the characteristics of hospitalized children with enema-reduced intussusception is crucial for optimizing care pathways.
Purpose of the Study:
- To detail the demographic and clinical profiles of children hospitalized after enema-reduced intussusception.
- To evaluate the necessity of hospitalization for these pediatric patients.
- To identify factors influencing hospitalization decisions in cases of enema-reduced intussusception.
Main Methods:
- Retrospective cross-sectional study involving patients aged 0-17 years.
- Analysis of hospitalized patients with enema-reduced intussusception at a children's hospital over a 12-year period.
- Definition of hospitalization necessity based on dehydration, persistent symptoms, need for repeat radiography, or serious complications.
Main Results:
- 45 patients (46 episodes) were hospitalized; 71% were male, with a median age of 10 months.
- 28% of episodes met criteria for potential hospitalization necessity (dehydration, abnormal labs).
- Minimal interventions were required during hospitalization; no serious complications like bowel perforation or sepsis were observed.
Conclusions:
- Hospitalized children with enema-reduced intussusception typically require limited interventions and have a low incidence of severe complications.
- The study findings support the consideration of outpatient management as a safe and viable alternative for select pediatric patients.
- Further research could refine criteria for outpatient management of enema-reduced intussusception.
Objectives:
To describe the demographic and clinical characteristics of hospitalized children with enema-reduced intussusception and to determine the necessity of hospitalization.
Methods:
Retrospective cross-sectional study of patients (0-17 years of age) with enema-reduced intussusception hospitalized at a 110-bed urban children's hospital. For this study, potential necessity of hospitalization was defined as the presence of associated dehydration, persistent symptoms and signs of intussusception requiring repeated radiographic studies, and/or enema-reduced serious complications (bowel perforation and/or sepsis).
Results:
For a 12-year period (January 1995 to December 2006), 45 patients who had enema-reduced intussusception were hospitalized. There were 32 males (71%). Three (6.7%) of the 45 patients had recurrent episodes of intussusception occurring at 2, 7, and 45 months after the initial episode. The initial episode for only 1 of these 3 was an enema-reduced hospitalization event. Thus, the following results include 46 episodes among 45 patientsThe mean (SD) age at the time of intussusception was 19.6 (25.4) months, and the median age was 10 months (range, 2-135 months). There were 27 episodes (59%) of patients 12 months or younger. The types of intussusception were ileocolic, 44 and ileoileum, 2. In 13 episodes (28%), patients were described as dehydrated and/or having an abnormal basic metabolic panel test result and meeting one of the study criteria for potential necessity of hospitalization. During the hospitalization, enema was repeated in 1 patient (2%) who had recurrent pain. The repeated enema was normal. No patient had a recurrent intussusception or developed signs of bowel perforation or sepsis while hospitalized. The mean (SD) hospital length of stay was 25.6 (9.9) hours, and the median time was 23 hours (range, 12-60 hours).
Conclusions:
Hospitalized children with enema-reduced intussusception required minimal interventions, had a low rate of signs and symptoms requiring further radiographic studies, and had no enema-reduced serious complications during hospitalization. These results support outpatient management as an acceptable alternative.
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