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Risk Factors of Nonsurgical Management Failure in Pediatric Intussusception Patients With Delayed Presentation

Ahmad Ali Davar1, Manijeh Khalili2, Amin Mashhadi1

  • 1From the Department of Radiology, School of Medicine.

Pediatric Emergency Care
|November 30, 2022
PubMed

Insights

Ultrasound-guided hydrostatic reduction (USGHR) failure in children with ileocolic intussusception is predicted by symptom duration, free peritoneal fluid, and entrapped fluid. These factors help anticipate reduction success in delayed presentations.

Area of Science:

  • Pediatric surgery
  • Radiology
  • Gastroenterology

Background:

  • Ileocolic intussusception is a common surgical emergency in children.
  • Delayed presentation increases the risk of complications and reduction failure.
  • Ultrasound-guided hydrostatic reduction (USGHR) is the preferred treatment, but predictors of failure require further investigation.

Purpose of the Study:

  • To identify time-related predictors of USGHR failure in pediatric ileocolic intussusception with delayed presentation (>48 hours).

Main Methods:

  • Retrospective study of 103 pediatric patients with ileocolic intussusception and symptom duration >= 48 hours.
  • Comparison of patients with successful versus failed USGHR based on age, sex, symptom duration, and ultrasound findings.
  • Statistical analysis using chi-squared and logistic regression tests.

Main Results:

  • 47.6% of patients achieved successful USGHR.
  • Symptom duration, free peritoneal fluid, entrapped fluid, invaginated segment size, and malperfusion were significant predictors of USGHR failure (P < 0.05).
  • No significant association found between USGHR failure and intussusception location or lymph nodes.

Conclusions:

  • Entrapped fluid, free peritoneal fluid, and longer intussuscepted segments are associated with USGHR failure.
  • Identifying these predictors can help anticipate reduction outcomes in delayed presentations.
Abstract

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