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Discharge Strategies Following Successful Ileocolic Intussusception Reduction: Hospitalization vs Emergency

Daniel M Cohen1, Sara Helwig1, Naveen Poonai2

  • 1Department of Pediatrics, The Ohio State University and Nationwide Children's, Columbus, OH.

The Journal of Pediatrics
|December 24, 2025
PubMed
Summary
This summary is machine-generated.

Discharging children from the emergency department after ileocolic intussusception reduction may increase return visits. However, both emergency department discharge and inpatient hospitalization show high success rates for recurrent intussusception re-reduction.

Keywords:
childrenhospitalizationintussusceptionobservationrecurrence

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Area of Science:

  • Pediatric Gastroenterology
  • Emergency Medicine
  • Surgical Outcomes

Background:

  • Ileocolic intussusception (ICI) is a common pediatric surgical emergency.
  • Successful reduction of intussusception can be followed by different discharge strategies.
  • Comparing inpatient hospitalization versus emergency department (ED) observation/discharge is crucial for optimizing care.

Purpose of the Study:

  • To compare the effectiveness and safety of two discharge strategies after successful ileocolic intussusception reduction.
  • To evaluate the rates of recurrent intussusception (re-ICI) and return to the ED based on discharge disposition.
  • To inform clinical decision-making regarding hospitalization versus ED discharge for children with ICI.

Main Methods:

  • A planned secondary analysis of a large international cohort of children (4 months to 4 years) with successful ICI reduction.
  • Data collected from 86 pediatric centers across 14 countries (2017-2019).
  • Evaluation of associations between discharge strategy (inpatient vs. ED discharge) and outcomes like ED return for re-ICI within 48 hours and the study period.

Main Results:

  • 2,686 ICI cases analyzed; 59% hospitalized, 41% discharged from ED.
  • Overall ED return for ICI was 8.9%; 10.2% of ED-discharged patients returned vs. 7.9% of hospitalized patients.
  • Patients discharged from the ED had a significantly higher odds of return within 48 hours (aOR=3.43) and within the study period (aOR=1.48) compared to hospitalized patients.
  • Re-reduction success rates were high and comparable in both groups (83.9%–94.1%).

Conclusions:

  • While ED discharge after successful ICI reduction may be associated with a higher risk of return visits for recurrent intussusception, the rates of successful re-reduction remain high.
  • The findings suggest that individualized assessment of risks and benefits is essential.
  • Clinicians should consider patient-specific factors to potentially avoid unnecessary hospitalizations while ensuring safety.