Recurrent Ileocolic Intussusception in Children: A Scoping Review

Background: Intussusception is the most common cause of acute intestinal obstruction in children. It can be initial idiopathic intussusception or a recurrent intussusception (RI), and in this latter case, there is not a validated algorithm for optimal treatment. The aim of the study is to review the international literature to evaluate the incidence of RI, to determine the rates of surgical intervention and pathological leading point (PLP), and to define the most appropriate management for children with RI. We included English-written papers with pediatric population, excluding case reports, papers with adult or mixed cases, studies focusing on ileo-ileal or colo-colic intussusception, meta-analysis studies, or papers with unclear or replaced data. Results: A total number of 23 articles were included for a total of 26,731 patients affected by intussusception and 3164 recurrent patients (11.8%). The number of attempts of nonsurgical reduction ranged from 3 to 10 (median 5). On 2965 RI, 358 underwent surgery (12.1%). A pathologic leading point was found in 99 patients (3.95%). Conclusions: The presence of a PLP does not seem to be associated with the recurrence of intussusception. More than 85% of RI underwent successful nonsurgical management. RI should be safely approached in the same way as primary intussusception, and surgery should be reserved to cases where a PLP has been suspected. In cases of multiple episodes, surgery can be considered an effective way to avoid recurrences, and this possibility should be discussed with parents.