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Management of childhood intussusception after reduction by enema

Andrea Wilkie Gilmore1, Martin Reed, Milton Tenenbein

  • 1Department of Pediatrics and Child Health, University of Manitoba, Children's Hospital, Winnipeg, Manitoba, Canada.

The American Journal of Emergency Medicine
|October 29, 2010
PubMed

Insights

Emergency department (ED) management after enema reduction for childhood intussusception is safe and effective. Most children can be discharged home with a low rate of early recurrence and no adverse events.

Area of Science:

  • Pediatric Gastroenterology
  • Emergency Medicine
  • Surgical Outcomes

Background:

  • Intussusception is a common pediatric surgical emergency.
  • Enema reduction is a standard treatment for intussusception.
  • The optimal disposition of patients after successful enema reduction remains debated.

Purpose of the Study:

  • To evaluate the safety and utility of emergency department (ED)/outpatient management following enema reduction for pediatric intussusception.
  • To determine the recurrence rates and outcomes associated with ED/outpatient versus inpatient care.

Main Methods:

  • Retrospective review of children aged 2 months to 6 years with intussusception treated with enema reduction.
  • Analysis of patient disposition (ED/outpatient vs. inpatient) and recurrence data (number, timing, outcome).
  • Assessment for adverse events such as perforation, sepsis, or bowel resection.

Main Results:

  • Of 56 eligible patients, 10 (18%) were admitted; 46 were managed in the ED/outpatient setting.
  • The overall recurrence rate was 12.5% (7/56 patients).
  • The early recurrence rate (within 24 hours) was 5.3%, with no adverse events reported in any patient.

Conclusions:

  • Outpatient management is feasible for the majority of children after successful enema reduction for intussusception.
  • Emergency department observation is a safe and effective strategy for uncomplicated cases, with a low rate of early recurrence.
  • Discharged patients with recurrence experienced favorable outcomes without serious complications.
Abstract

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