Factors Associated with Failure of Pneumatic Reduction in Children with Ileocolic Intussusception

Abstract

Intussusception is one of the most common causes of intestinal obstruction in children. Pneumatic reduction is the treatment of choice and has a high success rate. The most common cause of pneumatic reduction failure is the presence of a pathological leading point. We aimed to identify other factors that can lead to pneumatic reduction failure in children with ileocolic intussusception. This was a retrospective study conducted in two centers. Data were collected from January 2013 to December 2014. A total of 156 patients were diagnosed with intussusception and underwent pneumatic reduction, with the exception of one patient with peritonitis. We included patients with ileocolic-type intussusception without apparent pathological leading points. Logistic regression analysis of clinical parameters was performed to identify factors associated with pneumatic reduction failure. Of 156 patients diagnosed with intussusception in both hospitals, 145 were enrolled in the study. The overall efficacy of pneumatic reduction was 85.7%, and surgical reduction was performed in 21 patients. Univariate analysis showed that a high segmented neutrophil count, low hemoglobin level, high body temperature, and higher weight percentile were associated with pneumatic reduction failure. Multivariate analysis showed that a high segmented neutrophil count, low hemoglobin level, and higher weight percentile were significantly associated with pneumatic reduction failure. Pneumatic reduction is safe and effective as a first-line treatment for pediatric intussusception. However, a high segmented neutrophil count, low hemoglobin level, and higher weight percentile are associated with the failure of this treatment.

Risk factors and the establishment of nomogram model for failure of air enema reduction in children with Ileocolic Intussusception

“…It is worth noting that 90 cases (18.8%) of the enema treatments were found to be ineffective. The effectiveness of enema was found to be similar to the ndings reported by Soo-Min Jung et al [10] In cases where enema failed, surgical interventions such as intussusception reduction, enterectomy, and enterostomy were performed based on intraoperative conditions.In the present study, a cohort of 10 cases (2%) required emergency surgical intervention as part of their initial treatment, while 90 cases (18%) underwent surgery subsequent to unsuccessful enema attempts. Among the latter group, 14 cases (10%) underwent resection and enterostomy, revealing the presence of various pathological factors during the operation, including small intestine polyp, Meckel diverticulum, ectopic pancreas, and intestinal duplication.…”

Rotavirus vaccination is a protective factor for adverse outcomes in primary intussusception: a single-center retrospective study

“…Previous studies ( 1 , 3 , 35 ) found that longer duration of symptoms and bloody stool were associated with failed enema reduction, increased surgery and complications. Another meta-analysis ( 1 ) confirmed that age younger than 1 year, presence of fever and vomiting were risk factors for enema reduction failure.…”

Liberal surgical laparoscopy reduction for acute intussusception: experience from a tertiary pediatric institute

“…Timely reduction during the obstruction of bowel blood flow is vital for rescuing strangulated intussusception and consequently minimizing eventual bowel resection 11 , 12 . Traditionally, pneumatic enema reduction at maximum pressures of 100 mm Hg has been the first-line treatment for intussusception, boasting an overall success rate of up to 90% 13 . During our pre-protocol period, the majority of patients were successfully managed through pneumatic reduction.…”