Pneumatic reduction of intussusception: clinical experience and factors affecting outcome

Abstract

Between 1987 and 1992, 54 patients (32 male, 22 female) underwent 62 attempts at pneumatic reduction of intussusception. The mean age at presentation was 12.5 months (range 2.5 to 4 years 4 months). A retrospective review of all cases was performed to identify success rate and factors affecting it. Successful reduction was achieved in 46 cases (74%). One case was complicated by perforation and four cases (7%) by early recurrence. Patients with failed pneumatic reduction were more likely than those with successful reduction to have: (1) long duration of symptoms; (2) bleeding per rectum; (3) small bowel obstruction. Among the 16 cases of failed reduction, surgical findings were: five cases of ileo-ileo-colic intussusception, one with ileo-ileal, one with perforated ischaemic colon during air enema and one whose intussusception was found to be reduced at surgery. Three patients had lead points: Meckel's diverticula in two and a pinworm in one. Resection was required in three cases for non-viable bowel and in another two for the Meckel's diverticula. Pneumatic reduction of intussusception offers a high success rate with few complications. Performing an air enema earlier in the course of the disease may increase the chance of successful reduction.