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Indications for repeated enema reduction of intussusception in children

Dragana Vujović, Marija Lukac, Aleksandar Sretenović

    Srpski Arhiv Za Celokupno Lekarstvo
    |July 19, 2014
    PubMed

    Insights

    Delayed presentation significantly reduces the success of non-operative intussusception treatment. Early intervention with ultrasound-guided saline enema is crucial for successful reduction in children.

    Area of Science:

    • Pediatric Surgery
    • Gastroenterology
    • Emergency Medicine

    Background:

    • Intussusception is a frequent childhood abdominal emergency, often idiopathic.
    • Nonoperative hydrostatic or air enema reduction is the primary treatment.
    • Incidence ranges from 1.5-4 per 1,000 live births.

    Purpose of the Study:

    • To assess how clinical presentation and symptom duration impact non-operative intussusception treatment.
    • To evaluate indications for and efficacy of delayed enema reduction.

    Main Methods:

    • 102 pediatric patients with ileocolic intussusception underwent ultrasound-guided saline enema.
    • Symptom duration was analyzed as a predictor variable.
    • Outcomes of initial treatment, delayed enemas, and surgery were reviewed.

    Main Results:

    • Successful enema reduction occurred in 57% of patients (58/102).
    • Success rates were significantly higher with symptom duration < 24 hours (87%) versus > 24 hours (9%).
    • Children with symptoms > 24 hours had a 91% risk of requiring surgery.

    Conclusions:

    • Ultrasound-guided saline enema is highly accurate for intussusception reduction.
    • Delayed presentation markedly decreases non-operative treatment success.
    • Delayed enema reduction is a viable option, but surgery is necessary for complications.
    Abstract

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