Is every intussusception treatment an emergency intervention or surgery?

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Medical Diagnostics

Background:

• Intussusception is a common cause of acute abdominal pain in children, second only to appendicitis.
• Effective management strategies are crucial, particularly for small bowel intussusception.

Purpose of the Study:

• To evaluate the authors' experience in managing intussusception.
• To improve the understanding and treatment of small bowel intussusception.

Main Methods:

• Retrospective review of 81 pediatric intussusception cases from July 2002 to September 2014.
• Analysis of patient demographics, clinical presentation, diagnostic findings (ultrasound), and treatment outcomes.
• Categorization of intussusception types (ileocolic, ileoileal, jejunojejunal) and assessment of reduction methods.

Main Results:

• Ileocolic intussusception (52 cases) was most common; 45 underwent hydrostatic reduction.
• Small bowel intussusceptions (SBIs) in 17 patients (21%) spontaneously reduced, measuring 1.8-2.3 cm.
• Patients undergoing surgery had intussusceptums ≥4 cm; 3 of 4 intestinal resections were in patients with prior abdominal surgery.

Conclusions:

• Surgery is mandatory for intussusception with peritoneal irritation.
• For ileocolic intussusception without peritoneal signs, hydrostatic/pneumatic reduction is preferred; surgery follows if unsuccessful.
• SBIs <2.3 cm without peritoneal irritation have high spontaneous reduction rates; those >4 cm, especially with prior abdominal surgery, are unlikely to reduce spontaneously.