Delayed repeat enema in the management of intussusception

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Radiology

Background:

• Intussusception is a common surgical emergency in infants and children.
• Initial air enema reduction is the preferred treatment, but sometimes fails.
• Delayed repeat enemas offer a potential alternative to surgery after initial failure.

Purpose of the Study:

• To evaluate the effectiveness of delayed repeat air enema for intussusception after initial reduction failure.
• To identify predictors of successful reduction with delayed repeat enemas in pediatric patients.

Main Methods:

• Retrospective cross-sectional study of children with intussusception.
• Inclusion criteria: failed initial air enema, subsequent delayed repeat enema (≥2 hours).
• Analysis of demographic, clinical characteristics, and enema reduction success.

Main Results:

• Overall, 57% of delayed repeat enemas were successful in 20 patients (21 events).
• Success was significantly associated with initial reduction to the ileocecal valve (90% vs 33%).
• No significant differences in demographics or initial symptoms, but a trend for more severe symptoms in failed group.

Conclusions:

• Delayed repeat air enema is a viable option for clinically stable children with intussusception after initial enema failure.
• Achieving partial reduction to the ileocecal valve during the initial attempt predicts success with delayed repeat enemas.