Protocolized management of intussusception in children: optimizing pneumatic reduction outcomes

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Medical Devices

Background:

• Intussusception is a leading cause of pediatric intestinal obstruction.
• Pneumatic reduction is the primary non-operative treatment for intussusception.
• Factors like symptom duration and intussusception type can affect reduction success; the role of corticosteroids is unclear.

Purpose of the Study:

• To evaluate the outcomes of a standardized modified pneumatic reduction (MPR) protocol.
• To assess the efficacy and safety of MPR in pediatric intussusception.
• To investigate the potential role of hydrocortisone as an adjunct therapy.

Main Methods:

• Retrospective review of 92 admissions (79 patients) between May 2016 and October 2024.
• Implementation of a standardized MPR protocol using a manual sphygmomanometer.
• Selective use of intravenous hydrocortisone for specific indications.

Main Results:

• MPR demonstrated a 99% success rate with minimal complications (1% pneumoperitoneum).
• Recurrence rates were 16% early and 10% delayed.
• Hydrocortisone use in difficult cases correlated with a higher proportion of 'easy' reductions (47% to 83%, p=0.038).

Conclusions:

• A structured MPR protocol leads to high success and low complication rates in pediatric intussusception.
• MPR is effective even in challenging cases.
• Hydrocortisone may have a beneficial role in selected intussusception cases, meriting further research.