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Updated: Jun 18, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Factors associated with failure of hydrostatic reduction in children with ileocolic intussusception
Jie Xiong1, Hui Yang2, Tianliang Li3
1Department of Pediatric Surgery, Children's Emergency Center, The First People's Hospital of Zigong, Zigong, 643000, China. xjzhenong@126.com.
Insights
Infants under 1 year, prior intussusception history, prolonged symptoms, constipation, and bowel wall thickening increase the risk of failed hydrostatic enema reduction in children. These factors necessitate careful pediatric surgical evaluation.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Radiology
Background:
- Controversy exists regarding risk factors for failed hydrostatic enema reduction in pediatric ileocolic intussusception.
- Identifying these factors is crucial for optimizing treatment strategies and patient outcomes.
Purpose of the Study:
- To identify additional risk factors associated with unsuccessful hydrostatic enema reduction in children with ileocolic intussusception.
- To improve the prediction and management of treatment failures.
Main Methods:
- Retrospective study conducted at two tertiary centers.
- Inclusion of pediatric intussusception cases treated with ultrasound-guided hydrostatic reduction (January 2021-January 2025).
- Univariate and multivariate logistic regression analyses were performed.
Main Results:
- Hydrostatic reduction was successful in 86.2% of 231 patients; failure occurred in 13.8%.
- Significant risk factors for failure included: age under 12 months (OR=58.1), symptom onset >48 hours (OR=7.1), previous intussusception history (OR=42.7), constipation (OR=31.5), and bowel wall thickening on ultrasound (OR=8.2).
Conclusions:
- Age under 1 year, prior intussusception, symptom duration, constipation, and bowel wall thickening are key predictors of failed hydrostatic reduction.
- Older children with recurrent intussusception may have pathological leading points, increasing failure risk and requiring prompt surgical consultation.
Background/Objectives:
There remains controversy regarding the risk factors for failed hydrostatic enema reduction; therefore, we aimed to identify additional factors associated with unsuccessful hydrostatic enema reduction in children with ileocolic intussusception.
Methods:
This study was conducted retrospectively in two tertiary centers. Data were collected from patient charts or electronic medical records and consisted of pediatric intussusception cases treated with hydrostatic reduction during January 2021 and January 2025. Univariate and multivariate analyses, incorporating stepwise logistic regression, were conducted.
Results:
Two hundred thirty-one patients with ileocolic-type intussusception were included and treated by ultrasound-guided hydrostatic reduction at two different institutions. Hydrostatic reduction was successful in 199 patients (86.2%), failed in 32 (13.8%). All patients were successfully discharged with uneventful recoveries. On multivariate analysis, under 12-month-old(OR = 58.106,P < 0.001 95%CI,14.166-238.338),an Onset of symptoms>48 h (OR = 7.070,P = 0.014 95%CI,1.491-33.517), previous history of intussusception (OR = 42.721, P < 0.001 95%CI,5.729-318.572), constipation (OR = 31.488, P < 0.001 95%CI,5.597-177.137), and bowel Wall Thickening on US(OR = 8.177, P = 0.015 95%CI,1.513-43.553) were significantly associated with failed hydrostatic enema reduction.
Conclusions:
An age of under 1 year, previous history of intussusception, onset of symptoms, constipation, and bowel wall thickening on US were risk factors for failed hydrostatic reduction of ileocolic intussusception. Older children with long-term recurrent intussusception are at high risk of pathological leading points(PLPs) and hydrostatic reduction failure, requiring close pediatric surgical attention. Patients with these findings warrant early surgical consultation or transfer to a facility with pediatric surgical capabilities.
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