Colonoscopic reduction of pediatric ileocecal intussusception: a cross-sectional study comparing surgical and non-surgical reduction methods

Abstract

Introduction: One of the most frequent abdominal crises in pediatrics under the age of three is ileocolic intussusception. The aim of this study was to compare the outcome of colonoscopic reduction with the other more common types of reduction (radiologic and surgical).

Methods: The present study was a cross-sectional study including all children (up to 14 years) referred to the Amir-Al-Mominin Ali Hospital Zabol in the period from 2020 to 2024, with the final diagnosis of intestinal intussusception. The patients were divided into three groups: surgical, colonoscopic, and radiologic reduction, and the outcomes were compared. Using the program SPSS 22, the data were analyzed.

Results: Out of 60 radiologic attempts for intussusception reduction, three attempts (5%) were unsuccessful, leading to surgery. On the other hand, one of 60 colonoscopic reduction attempts, which were performed on patients diagnosed as optimal cases for colonoscopic reduction based on their diagnostic ultrasonography, was not successful. All 17 children who underwent surgery recovered well.

Conclusions: In the current study, the intussusception reduction success rate was 97.08%, and only four children experienced recurrence. The failure rate was around 5% in radiologic reduction and 1.67% in colonoscopic reduction. Our findings suggest that, in selected cases and in centers equipped with surgical backup, colonoscopy may be considered a feasible non-surgical option for ileocecal intussusception when performed by an experienced pediatric gastroenterologist in collaboration with a pediatric surgeon.

Keywords: Colonoscopy; Intestinal intussusception; Intussusception; Non-surgical reduction.