Current success in the treatment of intussusception in children

Background Intussusception remains a common cause of bowel obstruction in young children and results in significant morbidity and mortality if not promptly treated. The goal of this study was to determine the current success rate of radiologic reduction, the requirements for operative intervention, and the effect of delay in presentation on outcome. Methods Children treated for intussusception over a 15-year period were reviewed after treatment at a tertiary children’s hospital. Records were reviewed for patient outcomes from radiologic evaluation and surgical intervention. Results Two hundred forty-four children with intussusception were identified. Median age was 8.2 months (range, 16 days to 12.7 years). Eighty-seven percent of patients had ileocolic or ileoileocolic intussusception. The most common presenting symptoms were emesis (81%), hematochezia (61%), and abdominal pain (59%). Contrasted enemas were performed in 190 children, with successful reduction in 46%. Air-contrasted enema reduction was more successful than liquid-contrasted techniques (54% vs 34%; P = .017). Success in reduction was greater if symptom duration was 24 hours (59% vs 36%; P = .001). Despite failed prior attempts at reduction, 48% were reduced on reattempted enema reduction. One hundred forty children required surgical intervention for intussusception with 50% requiring bowel resection. Children with symptom duration >24 hours had a greater risk of requiring surgery (73% vs 45%; P < .001) and bowel resection (39% vs 17%; P = .001) than those with symptoms for