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Updated: Mar 12, 2026
Surgical Management of Meatal Stenosis with Meatoplasty
Published on: November 30, 2010
Age at presentation and management of pediatric intussusception: A Pediatric Health Information System database study
Kate B Savoie1, Fridtjof Thomas2, Simonne S Nouer2
1Department of General Surgery, University of Tennessee Health Science Center, Memphis, TN; College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN.
Insights
Enema reduction for intussusception is safe and effective in most children over 3 years old. This approach avoids increased operative intervention or lead point pathology in older pediatric patients.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Interventions
Background:
- Intussusception is rare in children over 3 years old.
- Enema reduction in older children is controversial due to concerns about operative intervention and lead points.
Purpose of the Study:
- To determine if older children (>3 years) face higher risks of operative intervention or lead point pathology.
- To evaluate the safety and efficacy of enema reduction in children over 3 years old.
Main Methods:
- Retrospective review of the Pediatric Health Information System database (2009-2014).
- Analysis of 7,412 pediatric intussusception cases, comparing patients <3 years and >3 years old.
- Follow-up for 6 months or until bowel resection; successful enema reduction defined as radiologic reduction without further procedures.
Main Results:
- 62% of children >3 years old (731 patients) had successful enema reduction.
- Tumor diagnosis rates were similar between age groups (5% vs 6%).
- Meckel's diverticulum diagnosis was higher in older children (14% vs 2%), but enema reduction was still successful for many.
Conclusions:
- Enema reduction appears safe and effective for the majority of children, including those over 3 years old.
- Older age was not linked to a higher risk of recurrent intussusception admissions.
- The findings support considering enema reduction for older children with intussusception.
Background:
Intussusception is uncommon in children older than 3 years, and use of enema reduction in older children is controversial. We sought to determine whether older children are at greater risk of requiring operative intervention and/or having pathology causing lead points, such that enema reduction should not be attempted.
Methods:
The Pediatric Health Information System database was reviewed from January 1, 2009-June 30, 2014. Patients were followed for 6 months from initial presentation or until bowel resection occurred. Successful enema reduction was defined as having radiologic reduction without additional procedures.
Results:
A total of 7,412 patients were identified: 6,681 were <3 years old, 731 patients were >3 years old. In those >3 years old, 450 (62%) were treated successfully with enema reduction; the rate of patients with a tumor diagnosis was similar in patients <3 years old and patients >3 years old (5% vs 6%, P = .07). The rate of a Meckel's diagnosis was greater in patients >3 years old (2% vs 14%, P < .0001). In patients >3 years old, duration of stay between patients who underwent primary operative therapy versus those who underwent operative therapy after enema reduction was similar (4 days vs 4 days, P = .06). Older age was not associated with increased risk of recurrent admission for intussusception (P = .45).
Conclusion:
Pediatric Health Information System data suggest that enema reduction may be safe and effective for a majority of children even if older than 3 years.
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