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Current methods for reducing intussusception: survey results

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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.

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Acknowledgments

We would like to acknowledge the assistance of Dr. Mark Lubell, Department of Environmental Science and Policy, University of California, Davis, in developing the survey.

Conflicts of interest

Dr. Stein-Wexler has a small financial interest in Lucy LLC, a company that produces a simulation device for learning intussusception reduction.

Author information

Authors and Affiliations

  1. Department of Radiology Pediatric radiology section, University of California, Davis Medical Center, 4860 Y St., Suite 3100, Sacramento, CA, 95817, USA

    Rebecca Stein-Wexler & Sandra L. Wootton-Gorges

  2. Department of Radiology, University of California, Davis, Medical Center, Sacramento, CA, USA

    Rachel O’Connor

  3. Department of Radiology Pediatric radiology section, Lucile Packard Children’s Hospital, Stanford School of Medicine, Stanford, CA, USA

    Heike Daldrup-Link

Authors
  1. Rebecca Stein-Wexler
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  2. Rachel O’Connor
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  3. Sandra L. Wootton-Gorges
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Correspondence to Rebecca Stein-Wexler.

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Stein-Wexler, R., O’Connor, R., Daldrup-Link, H. et al. Current methods for reducing intussusception: survey results. Pediatr Radiol 45, 667–674 (2015). https://doi.org/10.1007/s00247-014-3214-7

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  • DOI: https://doi.org/10.1007/s00247-014-3214-7

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