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Risk considered low for recurrent pediatric intussusception after enema reduction
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The risk for recurrence of pediatric ileocolic intussusception within 48 hours after enema reduction was low, according to recent study data.
Aiming to determine clinical recommendations, researchers from Wisconsin estimated 24-hour, 48-hour and overall recurrence rates by performing a systematic review and meta-analysis of 69 studies with a collective sample of 16,178 patients, sourced from PubMed, the Cochrane Database and OVID Medline from 1946 through 2011.
Inclusion criteria were cohorts with patients aged 18 years or younger, radiographic diagnoses of ileocolic intussusception reduced by enema, and documented or calculable numbers of total reductions and recurrences. Variables that could potentially affect recurrence also were recorded, including type of enema performed (contrast enema [CE], ultrasound-guided noncontrast enema [UGNCE], or fluoroscopy-guided air enema [FGAE]).
Rates of recurrence within 24 hours after reduction were 3.9% for CE (95% CI, 2.2%-6.7%), 3.9% for UGNCE (95% CI, 1.5%-10.1%) and 2.2% for FGAE (95% CI, 0.7%-6.5%). Rates within 48 hours were 5.4% for CE (95% CI, 3.7%-7.8%), 6.6% for UGNCE (95% CI, 4%-10.7%) and 2.7% for FGAE (95% CI, 1.2%-6.5%). Overall rates were 12.7% for CE (95% CI, 11.1%-14.4%), 7.5% for UGNCE (95% CI, 5.7%-9.8%) and 8.5% for FGAE (95% CI, 6.9%-10.4%).
These findings demonstrate “that an individual’s risk of having an early … recurrent intussusception after a successful enema reduction is low,” the investigators concluded. “In combination with the knowledge that serious postreduction complications are rare and that recurrences can be safely and successfully managed nonoperatively, it is reasonable to suggest that outpatient management in an appropriately selected population of well-appearing patients would be appropriate.”
Disclosure: The researchers report no relevant financial disclosures.
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