Current diagnosis and image-guided reduction for intussusception in children

Area of Science:

• Pediatric Gastroenterology
• Diagnostic Imaging
• Interventional Procedures

Background:

• Intussusception, the telescoping of one bowel segment into another, commonly affects the ileocolic region.
• Delayed diagnosis of intussusception can result in severe complications, including intestinal ischemia, infarction, and mortality.
• Prompt diagnosis and management are essential for favorable outcomes in pediatric intussusception.

Purpose of the Study:

• To review current concepts in the diagnosis and nonsurgical management of childhood intussusception.
• To highlight success rates, predictors of failure, complications, and recurrence of enema reduction.
• To provide guidance for pediatricians in managing intussusception.

Main Methods:

• Review of diagnostic modalities, emphasizing the role of abdominal radiography and ultrasonography.
• Discussion of nonoperative enema reduction techniques, including image guidance and reduction mediums.
• Analysis of factors influencing the success of enema reduction and potential complications.

Main Results:

• Ultrasonography is the preferred diagnostic tool for intussusception.
• Nonoperative enema reduction is a safe and effective primary treatment, with an overall success rate of 82%.
• Predictors of failed enema reduction include longer symptom duration, younger age, lethargy, fever, bloody diarrhea, and specific radiologic findings.

Conclusions:

• Early diagnosis via ultrasonography and prompt nonoperative enema reduction are vital for managing childhood intussusception.
• Understanding predictors of failed reduction and potential complications aids in clinical decision-making.
• This review offers a comprehensive guide for pediatricians on intussusception management, including recurrence and complications.