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Intussusception: influence of age on reducibility
Insights
Hydrostatic reduction for intussusception is 55% successful overall. Success rates are significantly lower in infants under three months old, prompting a review of this age group.
Area of Science:
- Pediatric Gastroenterology
- Radiology
Background:
- Intussusception is a common surgical emergency in infants.
- Hydrostatic reduction using barium enema is a primary treatment modality.
Purpose of the Study:
- To review the efficacy and safety of hydrostatic reduction for intussusception.
- To evaluate success rates across different age groups.
Main Methods:
- Retrospective review of 129 patients diagnosed with intussusception.
- Analysis of 115 attempted hydrostatic reductions over seven years.
Main Results:
- Overall success rate for hydrostatic reduction was 55% (63 out of 115 attempts).
- Success rate was significantly lower in infants aged 3 months and younger (20%) compared to older children (60%).
Conclusions:
- Hydrostatic reduction is moderately successful for intussusception.
- A reappraisal of hydrostatic reduction in infants under three months is recommended due to lower success rates and potential risks.
Abstract:
Our experience of hydrostatic reduction of intussusception by barium enema over the last 7 years is reviewed. There were 115 attempted hydrostatic reductions out of a total of 129 patients diagnosed as having intussusception on barium enema or at surgery. Age at presentation varied from one month to nine years, 81% of patients presenting before one year of age. Of 115 attempted reductions, 63 were successful giving an overall success rate of 55%. Looking at the different age groups, it was found that hydrostatic reduction was much less successful in infants aged 3 months and younger; success rate 20% compared to a 60% success rate in the remainder. Conscious of recent reports in the literature of bowel perforation during attempted hydrostatic reduction in young infants, we suggest that there should be a reappraisal of the role of hydrostatic reduction in the three months and younger age group.