Intussusception in infants and children: feasibility of ambulatory management

Masne, A. Le; Lortat-Jacob, S.; Sayegh, N.; Sannier, N.; Brunelle, Françis; Chéron, G.

doi:10.1007/s004310051184

Cited by 57 publications

(21 citation statements)

References 22 publications

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“…In a study by Le Masne et al, 20 54% of 92 children were managed as outpatients after successful reductions, with no subsequent adverse events other than an uncomplicated recurrence of the intussusception (16%). In another study by Gilmore et al, 14 82% of 56 children were discharged after a brief observation period of 7 hours and also had no adverse events other than recurrence (5.3%).…”

Section: Discussionmentioning

confidence: 99%

The Frequency of Postreduction Interventions After Successful Enema Reduction of Intussusception

Lessenich

Kimia

Mandeville

et al. 2015

Academic Emergency Medicine

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Objectives: The objective was to determine the frequency of postreduction, hospital-level interventions among children with successful reduction of ileocolic intussusception and identify factors that predict the need for such interventions.Methods: This was a retrospective cross-sectional study of children who underwent successful enema reduction for ileocolic intussusception at a single emergency department. Hospital-level interventions were included if they occurred within 24 hours of reduction and were further classified as either major (recurrence or possible perforation) or minor (imaging for suspected recurrence or administration of parenteral narcotics or antiemetics). Binary logistic regression was used to identify predictors for hospital-level interventions.Results: A total of 464 children underwent enema reduction. The median age was 1.7 years (interquartile range [IQR] = 0.8 to 2.5 years), and 66% were male. A total of 435 (94%) were hospitalized with a median hospital stay of 25 hours (IQR = 19 to 34 hours). Nineteen percent (95% confidence interval [CI] = 15% to 22%) needed postreduction interventions, including 6% (95% CI = 4% to 9%) who required major interventions. The median time to any hospital intervention was 9.9 hours (IQR = 6.3 to 16.4 hours). We identified two independent predictors for hospital-level interventions: duration of symptoms > 24 hours (adjusted odds ratio [OR] = 2.1, 95% CI = 1.3 to 3.4) and location of the intussusception tip at (or proximal to) the hepatic flexure (adjusted OR = 1.9, 95% CI = 1.1 to 3.3); the latter factor was also a predictor of a major intervention. None of the children (95% CI = 0 to 1.0%) had an acute decompensation after an initially successful enema reduction.Conclusions: Clinical decompensation is rare and recurrence is relatively low after an uncomplicated reduction of ileocolic intussusception. However, one in five children required hospital-level interventions after reduction. Children with the intussusception tip at (or proximal to) the hepatic flexure, and those with symptoms for longer than 24 hours, are more likely to require subsequent interventions. Although outpatient management appears safe after a period of observation, caregivers should be counseled about the risk of ongoing symptoms and recurrence.

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Section: Discussionmentioning

confidence: 99%

The Frequency of Postreduction Interventions After Successful Enema Reduction of Intussusception

Lessenich

Kimia

Mandeville

et al. 2015

Academic Emergency Medicine

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“…The treatment of intussusception has evolved from primarily operative management to the preference for non-operative reduction with either air or barium contrast. Non-operative reductions of intussusception had been shown to decrease length of hospitalization, shorten recovery, and reduce the risk of complications associated with major abdominal surgery [15]. Reports from some developing countries however indicate that for some ill-defined reasons, operative treatment is still routinely performed for intussusceptions [16-18].…”

Section: Introductionmentioning

confidence: 99%

Childhood intussusceptions at a tertiary care hospital in northwestern Tanzania: a diagnostic and therapeutic challenge in resource-limited setting

2014

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Background: Intussusception remains a common cause of bowel obstruction in children and results in significant morbidity and mortality if not promptly treated. There is a paucity of prospective studies regarding childhood intussusception in Tanzania and particularly the study area. This study describes the pattern, clinical presentations and management outcomes of childhood intussusception in our setting and highlights the challenging problems in the management of this disease. Methods: This was a prospective descriptive study of patients aged < 10 years operated for intussusception at Bugando Medical Centre. Ethical approval to conduct the study was obtained from relevant authorities. Data was analyzed using SPSS version 17.0.

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“…Most cases of intussusception are idiopathic and currently the initial management is pneumatic or barium reduction. The recurrence rate for non-surgical reduction is reported to be approximately 5% to 10% [3,4]. A large survey found that almost 50% of the instances of recurrent intussusception occurred within the 1st week of life [1,2], and is de®ned as early recurrent intussusception (ERI).…”

mentioning

confidence: 99%

Decreasing early recurrence rate of acute intussusception by the use of dexamethasone

Lin¹,

Kong

Houng³

2000

European Journal of Pediatrics

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Intussusception in infants and children: feasibility of ambulatory management

Cited by 57 publications

References 22 publications

The Frequency of Postreduction Interventions After Successful Enema Reduction of Intussusception

The Frequency of Postreduction Interventions After Successful Enema Reduction of Intussusception

Childhood intussusceptions at a tertiary care hospital in northwestern Tanzania: a diagnostic and therapeutic challenge in resource-limited setting

Decreasing early recurrence rate of acute intussusception by the use of dexamethasone

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