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Intussusception--current trends in management.

K W Liu, J MacCarthy, E J Guiney

    Archives of Disease in Childhood
    |January 1, 1986
    PubMed
    Summary
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    Barium enema reduction is an effective treatment for intussusception, with a 70% success rate and minimal complications. This procedure is recommended when available, excluding cases with pneumatosis intestinalis or peritonitis.

    Area of Science:

    • Pediatric Radiology
    • Gastroenterology

    Background:

    • Intussusception is a common surgical emergency in infants and children.
    • Prompt diagnosis and management are crucial to minimize morbidity.

    Purpose of the Study:

    • To evaluate the efficacy and safety of barium enema reduction for intussusception.
    • To identify factors associated with successful and unsuccessful reduction.

    Main Methods:

    • Retrospective review of 72 pediatric intussusception cases.
    • Barium enema reduction attempted in 65 cases.
    • Analysis of success rates, morbidity, mortality, and recurrence.

    Main Results:

    • Successful barium enema reduction in 51 (79%) of attempted cases, yielding an overall success rate of 70%.

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  • Average hospital stay was 3.5 days.
  • No mortality; 10% recurrence rate; minimal morbidity.
  • Unsuccessful reduction associated with shock, rectal bleeding, symptom duration >48 hours, and severe bowel obstruction (last two significant).

    • Conclusions:

    • Barium enema reduction is a safe and effective primary treatment for intussusception when performed by experienced pediatric radiologists.
    • Contraindications include pneumatosis intestinalis or peritonitis.
    • Careful patient selection and resuscitation are essential for optimal outcomes.