Multicenter analysis of time interval to intussusception reduction: Success and complication rates

Recent evidence shows that a 6-8 h interval between diagnosis and reduction of ileocolic intussusception does not negatively impact clinical outcomes. The goal of this study is to investigate the safe interval between diagnosis and non-operative reduction attempt for ileocolic intussusception.

This multicenter, retrospective review assessed enema reduction success and patient complications in ileocolic intussusception without lead point in patients aged 0-4 years over an 8 year period (2014-2021) in nine tertiary care institutions with subspecialty pediatric services.

Analysis of 1412 incidences of ileocolic intussusception (mean [SD] age, 19.2 [13.8] months; 61.8 % male) was performed. Most reductions, 96.3 %, were attempted within 8 h of imaging diagnosis. Reduction success at different intervals from diagnosis was relatively uniform: % success at time from diagnosis [N]: <8 h, 87.4 % [1359]; 8-12 h, 87.9 % [33]; >12 h, 90 % [20]. Success declined to 66.7 % > 24 h after diagnosis [3 cases]. Surgical reduction was performed in 12.7 % of cases [179]; of these, 27.9 % [50] were complicated, requiring bowel repair and/or resection. Rates of surgery (12.7 % < 8 h, 12.1 % 8-12 h, 10.0 % > 12 h, p = 0.94) and the rate of complicated intussusception (27.7 % < 8 h, 25 % 8-12 h, 50 % > 12 h [1 of 2 patients], p = 0.78) did not significantly increase with increasing time after diagnosis.

Success rate of enema reduction of ileocolic intussusception is maintained out to 8 h from diagnosis, without increased complications. These findings support the cautious modification of the standard of care for ileocolic intussusception in appropriately selected patients.