Nonsurgical management of childhood intussusception: retrospective comparison between sonographic and fluoroscopic...

The purpose of this study was to compare the effectiveness of sonography and fluoroscopy in guiding intussusception reduction and evaluate possible complications for each procedure.

A retrospective analysis was performed by reviewing 31 cases of intussusception diagnosed and managed between January 2009 and January 2014 at the University of California, Davis Children's Hospital, after obtaining approval from the Institutional Review Board. To eliminate other confounding factors related to technique and experience, only cases performed by 2 pediatric radiologists who exclusively used either fluoroscopy or sonography were compared.

Fourteen patients (age range, 6-35 months) were treated by sonographic guidance using saline, and another 17 patients (age range, 2-57 months) were treated by fluoroscopy using either air or a water-soluble contrast agent. All 14 patients (100%) who underwent sonographically guided reduction were successfully treated without complications. Fourteen of the 17 patients (82%) who underwent fluoroscopic guidance had successful reductions. One complication of perforation was documented.

Sonography and fluoroscopy are equally effective in the nonsurgical management of childhood intussusception. The absence of ionizing radiation and better visualization of possible pathologic lead points makes sonography the ideal method.