Initial Fluid Resuscitation Increases Risk of Failed Pneumatic Reduction of Intussusception

Intussusception is considered to be the most common cause of small bowel obstruction in children. Because of complications secondary to intussusception, prompt diagnosis based on clinical presentation and confirmatory ultrasound is critical. First-line treatment is nonoperative reduction by pneumatic enema, and standard practice before reduction involves IV fluid resuscitation. [...]IV fluid resuscitation has traditionally been recommended as a first-line treatment regardless of intervention approach.2,10 A recent metaanalysis on enema reduction stressed the importance of identifying interventions that may improve or hinder the reduction of well-appearing intussusception patients.16 Widespread IV fluid resuscitation is one such factor, as a paucity of literature exists on its etiology. [...]the authors noticed that this apparent dogma of IV fluid resuscitation was not being applied consistently at their institution. [...]IV fluid resuscitation before fluoroscopic reduction of intussusception may be a risk factor for failed reduction.