Ileocolic intussusception: hydrostatic reduction in the presence of the dissection sign

Area of Science:

• Pediatric radiology
• Gastrointestinal imaging
• Surgical emergencies

Background:

• Intussusception is a common surgical emergency in infants and children.
• Hydrostatic reduction is a primary non-surgical treatment for intussusception.
• Barium dissection around the intussusceptum is typically a contraindication for continued hydrostatic reduction.

Observation:

• A case of ileocolic intussusception is presented where barium dissected around the intussusceptum.
• This barium dissection was initially considered to necessitate termination of the reduction procedure.
• The intussusception was successfully reduced after draining and re-insufflating the colon with barium.

Findings:

• Successful hydrostatic reduction of intussusception was achieved despite initial barium dissection.
• A novel technique involving colonic decompression and re-insufflation facilitated reduction.
• This challenges the established contraindication for barium dissection during hydrostatic reduction.

Implications:

• This case suggests that barium dissection may not always be an absolute contraindication for hydrostatic reduction.
• The described technique may offer an alternative approach in difficult intussusception cases.
• Further investigation into this technique could refine management protocols for pediatric intussusception.