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Intussusception in children: reduction with repeated, delayed air enema
A Gorenstein1, A Raucher, F Serour
1Division of Pediatric Surgery, Edith Wolfson Medical Center, Holon, Israel.
Radiology
|March 12, 1998
Summary
Repeated, delayed pneumatic reduction for intussusception significantly improves success rates. This approach enhances outcomes by allowing multiple air enema trials, especially in longer-presenting cases.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Intussusception is a common surgical emergency in infants and children.
- Pneumatic reduction is a standard, non-operative treatment for intussusception.
Purpose of the Study:
- To evaluate the efficacy of pneumatic reduction for intussusception.
- To determine the impact of repeated, delayed air enema trials on treatment success.
Main Methods:
- Seventy-one patients with intussusception underwent pneumatic reduction using air enemas.
- Treatment protocols were compared: single trial (pre-1993) vs. up to three trials (post-1993).
- Patients were stratified by symptom duration: <12 hours, 12-24 hours, >24 hours.
Main Results:
- Overall success rate for pneumatic reduction was 83% (59/71).
- Success rates improved significantly since 1993 with repeated trials (91% vs. 70%, P < .05).
- Higher success rates were observed in shorter symptom duration groups, but repeated trials benefited all groups.
Conclusions:
- Repeated, delayed pneumatic reduction significantly enhances treatment outcomes for intussusception.
- The strategy of allowing multiple air enema attempts is crucial for improving success rates.
- Pneumatic reduction remains a safe and effective primary treatment for intussusception with no reported complications.