Our treatment approaches in recurrent chronic intussusceptions

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Medical Devices

Background:

• Intussusception is a common cause of intestinal obstruction in young children.
• Recurrent intussusception occurs in 5-16% of cases and presents treatment challenges, particularly without a clear lead point.
• The etiology of intussusception is often idiopathic in 75-90% of patients.

Purpose of the Study:

• To review a decade of experience with recurrent intussusception.
• To describe a new surgical technique for recurrent intussusception lacking a lead point.

Main Methods:

• Retrospective review of 33 patients with recurrent intussusception (2007-2017).
• All patients underwent ultrasound-guided hydrostatic reduction (UGHR).
• Surgical intervention (laparoscopy or laparotomy) was reserved for acute abdomen, complete obstruction, or failed UGHR, with a novel laparoscopic ileal folding and fixation technique described for one patient.

Main Results:

• A total of 87 UGHRs were performed on 33 patients.
• The success rate for the second UGHR was 81.8% (27/33).
• Six patients required surgery; one underwent the new laparoscopic ileal folding and cecal fixation technique.

Conclusions:

• Ultrasound-guided hydrostatic reduction is effective for recurrent intussusception.
• Laparoscopy aids in diagnosis and treatment of irreducible intussusception.
• The described laparoscopic technique provides a satisfactory option for recurrent intussusception without a lead point.