Transabdominal manually assisted reduction of pediatric intussusception: reappraisal of this historical technique.
OBJECTIVE
To determine whether manual manipulation of the abdomen during intussusception reduction improves the success rate or affects morbidity.


METHODS
A retrospective study was performed in 38 cases of intussusception in 35 children over a 33-month period at a pediatric hospital. In all cases, pneumostatic pressure was used as the initial method of treatment. A comparative review of the intussusception literature was also performed.


RESULTS
Reduction was achieved with pneumostatic pressure alone in 22 cases (an initial success rate of 58%). Transabdominal manual manipulation was used in 10 cases after initial pneumostatic reduction failed; seven of these 10 cases were treated successfully. These seven additional successes, attributed to manual assistance, significantly improved the success rate from 58% to 76% (P < .016). No perforation or other complication occurred.


CONCLUSIONS
These results and findings of the literature review indicate that transabdominal manual assistance during reduction is a potentially useful technique that has been shunned without scientific basis for longer than 40 years.
Grasso
S N
SN
Department of Radiology, Children's Hospital of the King's Daughters, Norfolk, Va.
Katz
M E
ME
Presberg
H J
HJ
Croitoru
D P
DP
D000399:Air Pressure; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007443:Intussusception / Q000628:therapy*; D008297:Male; D008722:Methods; D012189:Retrospective Studies