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Updated: Jul 3, 2026
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Published on: July 12, 2024
Point-of-Care Ultrasound-Guided Hydrostatic Reduction of Ileocolic Intussusception in the Pediatric Emergency
Sara A Zymerman1, Natan Cramer2, Adi Klein1
1Pediatric Department, Hillel-Yaffe Medical Center, Hadera, Israel; Technion - Israel Institute of Technology, Haifa, Israel.
Insights
Point-of-care ultrasound (POCUS)-guided hydrostatic reduction for ileocolic intussusception in children is safe and effective. Performed by pediatric emergency medicine (PEM) physicians, this bedside procedure showed an 88.9% success rate with no complications.
Area of Science:
- Pediatric Emergency Medicine
- Gastroenterology
- Medical Imaging
Background:
- Intussusception is a common surgical emergency in infants and children.
- Traditional reduction methods often involve fluoroscopy, carrying radiation risks.
- Bedside ultrasound (POCUS) offers a radiation-free alternative for diagnosis and intervention.
Purpose of the Study:
- To evaluate the feasibility and outcomes of POCUS-guided hydrostatic reduction of ileocolic intussusception.
- To assess the role of pediatric emergency medicine (PEM) physicians in performing this procedure.
- To describe the safety, efficacy, and time to intervention.
Main Methods:
- A case series of children aged 3–36 months with ileocolic intussusception was conducted.
- Bedside POCUS-guided hydrostatic reductions were performed by a PEM physician.
- Data collected included procedural success, time to reduction, complications, and recurrence.
Main Results:
- Nine POCUS-guided hydrostatic reductions were performed.
- Successful reduction was achieved in 8 out of 9 (88.9%) cases.
- Median time from arrival to reduction was 1.69 hours; no complications or recurrences were observed within 24 hours.
Conclusions:
- POCUS-guided hydrostatic reduction by PEM physicians is a safe and efficient bedside treatment for ileocolic intussusception.
- This method avoids radiation exposure and may expedite treatment, especially in resource-limited settings.
- Larger studies are warranted to confirm these findings.
Study Objective:
Our study objective was to describe our experience with POCUS-guided hydrostatic reductions of ileocolic intussusception performed by a PEM physician at the bedside in the pediatric emergency department (PED).
Methods:
We describe a case series of children aged 3 to 36 months with ileocolic intussusception in the PED who received a bedside POCUS-guided hydrostatic reduction between May 2022 and November 2025 in our secondary care hospital. Data collected included the time from presentation to successful POCUS-guided hydrostatic reduction, success rate, complications, and 24-hour recurrence.
Results:
A total of 9 bedside POCUS-guided hydrostatic reductions were performed in the PED by a PEM provider. Successful reduction was achieved in 8 out of 9 (88.9%) cases. The median time from PED arrival to successful POCUS-guided reduction was 1.69 hours (interquartile range 1.04 to 2.45). No complications or 24-hour recurrences occurred. One unsuccessful case was later identified to have a lead point requiring definitive surgical repair.
Conclusion:
Our case series of POCUS-guided hydrostatic reduction performed by a trained PEM physician at the bedside in the PED appears to highlight a safe and expedient form of treatment for ileocolic intussusception. This approach eliminates radiation exposure and may shorten time to intervention in certain cases, particularly in settings without dedicated pediatric radiology services. Further larger studies are needed to validate our findings.
