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Is enema reduction in pediatric intussusception with a history of over 48 h safe: A retrospective cohort study

Shu Ting Liu1, Yi Feng Li1, Qian Yun Wu1

  • 1Department of Pediatric Surgery, Shengjing Hospital, China Medical University, Shenyang 110004, PR China.

The American Journal of Emergency Medicine
|March 11, 2023
PubMed

Insights

Enema reduction is safe and effective for pediatric intussusception, even after 48 hours. This treatment shows high success rates and low recurrence, challenging previous contraindications for prolonged cases.

Area of Science:

  • Pediatric Gastroenterology
  • Surgical Emergencies
  • Medical Imaging

Background:

  • Intussusception is a common pediatric abdominal emergency.
  • Enema reduction is the standard first-line treatment.
  • A history exceeding 48 hours has traditionally been a contraindication for enema reduction.

Purpose of the Study:

  • To analyze the safety and efficacy of enema reduction in children with intussusception lasting longer than 48 hours.
  • To evaluate if prolonged disease history impacts treatment outcomes.

Main Methods:

  • Retrospective matched-pair cohort study (2017-2021).
  • Ultrasound-guided hydrostatic enema reduction used for all patients.
  • Comparison of outcomes between groups with disease history <48 hours and ≧48 hours, matched for key demographic and clinical factors.

Main Results:

  • No significant difference in success rates (98.18% vs. 97.37%) or recurrence rates (13.36% vs. 11.94%) between the ≧48h and <48h groups.
  • Perforation rates were similar (0.61% vs. 0%), indicating comparable safety.
  • History length did not significantly affect outcomes in patients with bloody stools.

Conclusions:

  • Ultrasound-guided hydrostatic enema reduction is a safe and effective treatment for pediatric idiopathic intussusception, regardless of disease duration.
  • The 48-hour mark is not an absolute contraindication for enema reduction in children.
  • This finding supports the expanded use of enema reduction for prolonged intussusception cases.
Abstract

Keywords:
Enema reductionIntussusceptionLength of historyPediatric

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