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Early recurrence of ileocolic intussusception after successful air enema reduction: incidence and predisposing
Natalia Simanovsky1, Omer Issachar2, Benjamin Koplewitz2
1Department of Medical Imaging, Hadassah Medical Center, Hadassah Hebrew University, PO Box 24035, Mount Scopus, 91240, Jerusalem, Israel. natalias@hadassah.org.il.
Insights
Early recurrent ileocolic intussusception (RICI) is rare, occurring in 2.45% of cases. Winter months and older age were identified as potential risk factors for RICI in children.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Ileocolic intussusception (ICI) is a common cause of intestinal obstruction in infants and children.
- Early recurrent ileocolic intussusception (RICI) is an uncommon event following initial successful enema reduction.
Purpose of the Study:
- To determine the incidence rate of RICI.
- To identify predisposing factors associated with early recurrence of ICI in children.
Main Methods:
- Retrospective analysis of 245 ICI episodes in 210 pediatric patients treated between 2005-2015.
- Data collected included demographics, clinical presentation, imaging, and laboratory findings.
- Early RICI was defined as recurrence within 48 hours of initial reduction.
Main Results:
- Six patients (2.45%) experienced RICI, with recurrence occurring 7-28 hours post-reduction.
- RICI was significantly associated with winter months (83.3% of recurrences vs. 19.6% of non-recurrences, p=0.001).
- Patients with RICI were older (mean 23 months) compared to those without recurrence (mean 12.4 months, p=0.016).
Conclusions:
- RICI is a rare complication after successful enema reduction for ICI.
- Predisposing factors for RICI include presentation during winter months and older age.
- Routine admission and prolonged observation for all cases may not be necessary; an individualized approach is recommended.
Purposes:
Early recurrent ileocolic intussusception (RICI) is a rare event. We aimed to estimate the rate of RICI and identify predisposing factors for early recurrence for children treated in a tertiary-care academic medical center.
Methods:
Consecutive children who were diagnosed with ileocolic intussusception (ICI) during the years 2005-2015 and had successful enema reduction were included. Demographic, clinical, imaging, and laboratory data were recorded for analysis. Ultrasound and fluoroscopy images were reviewed. Early RICI was defined as recurrence within 48 h.
Results:
Two hundred forty-five episodes of intussusception in 210 patients, ages 2 to 77 months (mean 12.7), were included. Six patients (2.45%) had a RICI between 7 and 28 h (mean 17 h) after initial successful reduction. A total of 5/6 recurrences (83.3%) were in winter months. In the group without early recurrence, only 19.6% of the cases presented during the winter (p = 0.001). Mean age in the early recurrence group was 23 months compared to 12.4 months children with no early recurrence (p = 0.016). All other analyzed parameters were comparable for the groups.
Conclusion:
Early RICI is a relatively rare event that may not justify routine admission and long observation. The approach should be individual, based on the clinical picture.
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