Intussusception: a repeat delayed gas enema increases the nonoperative reduction rate

Area of Science:

• Pediatric Surgery
• Gastroenterology

Background:

• Intussusception is a common surgical emergency in children.
• The operative rate for intussusception has decreased due to expanded enema reduction indications and the use of gas enemas over barium.

Purpose of the Study:

• To evaluate the efficacy of a delayed repeat gas enema in pediatric intussusception cases with initial partial reduction.
• To determine if this strategy can further reduce surgical intervention rates.

Main Methods:

• A prospective study involving 156 children with intussusception.
• Twenty-one clinically stable patients with partial reduction underwent a delayed repeat gas enema (≥30 minutes after the initial attempt).

Main Results:

• The delayed repeat gas enema achieved successful reduction in over 50% of the selected patients.
• This intervention reduced the number of patients requiring surgery by 24% at the institution.
• Estimated annual savings of approximately five children from surgery per institution.

Conclusions:

• A delayed repeat gas enema is a valuable strategy for clinically stable children with partial intussusception reduction.
• This method effectively reduces the need for operative intervention in pediatric intussusception.
• Optimizing non-operative management can significantly impact surgical caseloads for intussusception.