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Updated: Apr 18, 2026
08:49
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
17.7K
Operative indications in recurrent ileocolic intussusception
Jeremy G Fisher1, Eric A Sparks1, Christopher G B Turner1
1Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA.
Journal of Pediatric Surgery
|January 20, 2015
Summary
Air-contrast enema (ACE) is effective for recurrent intussusception. While recurrence increases resection risk, it does not predict complications, supporting ACE as standard treatment.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Radiology
Background:
- Air-contrast enema (ACE) is the standard treatment for primary ileocolic intussusception.
- The optimal management strategy for recurrent intussusception remains less defined.
- Understanding recurrence patterns is crucial for guiding therapeutic decisions.
Purpose of the Study:
- To quantify the relationship between intussusception recurrence and the need for bowel resection.
- To assess the association between recurrence, pathologic lead points (PLP), and complication rates.
- To delineate appropriate therapeutic strategies for recurrent intussusception.
Main Methods:
- Retrospective review of 716 patients with intussusception from 1997 to 2013 at a single institution.
- Data collected included recurrences, outcomes, and complications.
- Statistical analysis using Fisher's exact and t-tests.
Main Results:
- Of 666 ileocecal intussusceptions, 14% recurred after ACE.
- Recurrence did not predict pathologic lead points (PLP) but was associated with a higher resection rate (P=0.03) when occurring three or more times.
- Successful initial ACE had a 98% negative predictive value for resection and PLP; failed ACE significantly increased the risk of PLP and resection (P<0.001).
Conclusions:
- Intussusception recurrence is linked to an increased risk of bowel resection but not PLP or ACE-related complications.
- Failed initial ACE is a significant predictor of harboring PLP and requiring resection.
- ACE should remain the standard treatment for recurrent intussusception, irrespective of the number of recurrences.
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