Related Experiment Video
Updated: Apr 29, 2026
Evaluation of the Effectiveness of Longitudinal Incision for Endoscopic Submucosal Excavation of Gastric Subepithelial Lesions
Published on: April 28, 2026
Comparative outcome analysis of the management of pediatric intussusception with or without surgical admission
Alana L Beres1, Robert Baird1, Eleanor Fung2
1The Montreal Children's Hospital, Pediatric General and Thoracic Surgery, McGill University Health Centre.
Insights
Pediatric intussusception patients can be safely discharged from the emergency department (ED) after reduction. This approach reduces hospital costs without increasing recurrence or morbidity, making it a viable management strategy.
Area of Science:
- Pediatric Surgery
- Emergency Medicine
- Healthcare Economics
Background:
- Debate exists regarding the necessity of hospital admission for pediatric intussusception post-reduction.
- Current practices vary, impacting patient management and healthcare costs.
Purpose of the Study:
- To evaluate the safety and efficacy of discharging pediatric intussusception patients from the emergency department (ED) after successful reduction.
- To assess the impact of outpatient management on recurrence rates, morbidity, and healthcare costs.
Main Methods:
- A 10-year retrospective chart review was conducted at two Canadian institutions.
- Data included patient demographics, length of stay (LOS), recurrence rates, and management strategies.
- Hospital costs were calculated based on institution-specific data.
Main Results:
- Outpatient management of 239 pediatric intussusception patients showed recurrence rates (8.8%) comparable to admitted patients (8.5%).
- No significant difference in operative intervention rates was observed between groups.
- Discharging patients from the ED resulted in average LOS of 90 hours less and cost savings of $1771 per non-operated patient.
Conclusions:
- Pediatric intussusception can be safely managed as an outpatient following successful reduction with appropriate follow-up.
- Emergency department discharge significantly reduces hospital charges without compromising patient safety or increasing morbidity.
- This outpatient management strategy should be considered for eligible pediatric intussusception patients.
Background:
Controversy persists about the need to admit patients after successful reduction of intussusception. Our hypothesis is that pediatric intussusception can be managed with discharge from the emergency department (ED) after reduction without increasing morbidity, yielding significant cost savings.
Methods:
A chart review over 10 years was performed at two Canadian institutions. Data abstracted included: demographics, length of stay (LOS), initial and recurrence management. Primary outcome was early recurrence and resultant management, including LOS and need for operative intervention. Costs were calculated using hospital-specific data.
Results:
584 patient records were assessed: 329 patients were managed with admission after reduction, 239 as outpatients. In the admission group, 28 patients had at least one recurrence (8.5%), with 8 after discharge. In the outpatient group, 21 patients had at least one recurrence (8.8%), with 19 after discharge. The difference post-discharge was significant (p=0.004). Outcomes of recurrence did not differ, with 2 patients in each group requiring operative intervention. Average LOS in the admission group was 90 h, with additional average cost of $1771 per non-operated patient.
Conclusions:
Pediatric intussusception can be safely managed as an outpatient with reliable follow up. Discharge from the ED reduces hospital charges without increasing morbidity. This approach should be considered in managing patients with intussusception.
Related Concept Videos
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:25Urinary Tract Calculi VI: Surgical Management
01:26Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease