Ultrasound-guided reduction of intussusception: a safe and effective method performed by pediatric surgeons

Abstract

Objectives: Ultrasound has developed as the method of choice for diagnosing intussusception. Ultrasound-guided enema reduction is the standard method for treating intussusception. This retrospective study evaluates the efficacy and safety of ultrasound in diagnosis and treatment of intussusception performed solely by pediatric surgeons.

Methods: Charts were studied of all patients who were treatedfor intussusception in our unit from 2013 to 2015. Primary outcome measure was the completeness of reduction, and secondary outcome measure was the rate of complications and elapsed time until surgical treatment.

Results: We included 38 patients in this retrospective study. The mean age was 16.7 months (±15), and the female to male ratio was 1:2. Diagnosis was established by abdominal ultrasound. Thirty-five of thirty-eight patients underwent ultrasound-guided enema reduction at our institution. Three of thirty-eight patients were scheduled for immediate surgery due to signs of peritonitis or prolonged bowel obstruction. The overall rate of successful ultrasound enema reduction was 28/35 (80 %) patients. Seven of thirty-five patients underwent surgery after an unsuccessful enema reduction; 6/7 patients had a prolonged history of symptoms, and 6/7 patients had a specific pathological lead point. The length of hospitalization was less than 2 days for patients after enema reduction. Recurrence was observed in three cases (8.5 %). We did not observe any complications during enema reduction.

Conclusions: Ultrasound-guided enema reduction for intussusception is safe and effective when performed by pediatric surgeons.

Keywords: Enema; Intussusception; Pediatric surgeon; Ultrasound.