Predictors of successful air enema reduction of intussusception in infants younger than 4 months

Abstract

Objectives: Intussusception is rare in infants younger than 4 months, and the use of air enema for reduction of intussusception has been limited. In this retrospective study, we analyzed the predictors of successful reduction of intussusception using air enema in infants younger than 4 months.

Methods: This is a retrospective chart review of 97 intussusception patients of younger than 4 months between January 2008 and December 2012. Demographic data, clinical presentation, and outcomes of air enemas were collected and analyzed. We used univariate and multivariate logistic regression analyses for significant predictors of successful reduction of intussusception using air enemas.

Results: Of the 97 infants younger than 4 months (median age 97.6 days, age range 41-119 days), 63 (65%) were boys and 34 (35%) were girls. The duration of symptoms ranged from 5 to 53 hours, with a median of 16.3 hours. The clinical features included paroxysmal crying (75%), vomiting (68%), bloody stools (61%), and palpable abdominal masses (32%). The duration of symptoms, bloody stools, and the shape of the intussusceptum were found to be significantly predictive of the outcome of air enema reduction of intussusception.

Conclusions: The rate of successful reduction of intussusception using air enemas in infants younger than 4 months is low. Factors such as the duration of symptoms, bloody stools, and the shape of the intussusceptum are predictive of the outcome of air enema reduction of intussusception.