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Emergency department discharge following successful radiologic reduction of ileocolic intussusception in children: A

Joseph A Sujka1, Brian Dalton2, Katherine Gonzalez3

  • 1Department of Surgery, Children's Mercy Hospital, Kansas City, MO 64108.

Journal of Pediatric Surgery
|October 13, 2018
PubMed

Insights

Emergency department observation and discharge after successful air enema reduction for pediatric intussusception is safe. This protocol allows for earlier discharge and reduces hospital resource use.

Area of Science:

  • Pediatric Gastroenterology
  • Emergency Medicine
  • Surgical Outcomes

Background:

  • Fluoroscopic guided air enema reduction is the primary treatment for pediatric intussusception.
  • Typically, patients undergo overnight hospital admission for observation post-procedure.

Purpose of the Study:

  • To evaluate the safety and efficacy of an emergency department (ED) observation and discharge protocol for children with ileocolic intussusception following successful air enema reduction.

Main Methods:

  • A prospective observational study compared patients managed under a new ED protocol (2014-2017) with a historical cohort (2011-2014).
  • Data included demographics, ED and hospital times, reduction success, recurrence, and operative intervention rates.

Main Results:

  • The prospective protocol group (115 patients) showed a shorter median hospital time post-enema (4.8h vs. 19.7h, p<0.01) compared to the historical cohort (90 patients).
  • Successful reduction rates ranged from 84%-89%.
  • Only 33% of patients were admitted under the protocol, most commonly for abdominal discomfort.

Conclusions:

  • Emergency department observation and discharge after successful air enema reduction in pediatric intussusception is a safe strategy.
  • This approach facilitates earlier patient discharge and optimizes hospital resource utilization.
Abstract

Keywords:
Air enema reductionIleocolicIntussusceptionPediatrics

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