Current methods for reducing intussusception: survey results

Rebecca Stein-Wexler, Rachel O’Connor, Heike Daldrup-Link, Sandra L. Wootton-Gorges

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Background: Intussusception is a common pediatric abdominal emergency, treated with image-guided reduction. Available techniques include fluoroscopic and ultrasonographic monitoring of liquid and air. Objective: The purpose of this study was to determine current practices and establish trends by comparing our findings with reports of previous surveys. Materials and methods: This study is based on an e-mail survey sent to all 1,538 members of the Society for Pediatric Radiology. It included questions about demographics, presence of parents/surgeon during procedure, patient selection/preparation, use of sedation, preferred methods of reduction and technical details, approach to unsuccessful reduction, and self-reported incidence of success/perforation. Results: The 456 respondents (30%) reported attempting 3,834 reductions in the preceding 12 months. Of these, 96% use fluoroscopy and 4% use US guidance for reduction; 78% use air, 20% prefer fluid; 75% require intravenous access; 63% expect a surgeon to be present in hospital; 93% do not sedate. Although inflating a rectal balloon is controversial, 39% do so, and 50% employ a pressure-release valve. Seventy-two percent attempt reductions three times in the same position. In case of unsuccessful reductions, 64% wait and re-attempt later, 19% apply manual pressure, and 15% try again in left decubitus position. About 20% reattempt reduction after waiting 2 h or more. Conclusion: By providing a better understanding of both trends in and diversity of current practice, we hope to increase the confidence with which the individual practitioner will approach each case.

Original languageEnglish (US)
Pages (from-to)667-674
Number of pages8
JournalPediatric Radiology
Volume45
Issue number5
DOIs
StatePublished - Nov 29 2014

Keywords

  • Intussusception
  • Intussusception reduction
  • Pediatric
  • Practice patterns
  • Survey

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Pediatrics, Perinatology, and Child Health

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