title: Pneumatic reduction of intussusception: clinical experience and factors affecting outcome.
abstract: Between 1987 and 1992, 54 patients (32 male, 22 female) underwent 62 attempts at pneumatic reduction of intussusception. The mean age at presentation was 12.5 months (range 2.5 to 4 years 4 months). A retrospective review of all cases was performed to identify success rate and factors affecting it. Successful reduction was achieved in 46 cases (74%). One case was complicated by perforation and four cases (7%) by early recurrence. Patients with failed pneumatic reduction were more likely than those with successful reduction to have: (1) long duration of symptoms; (2) bleeding per rectum; (3) small bowel obstruction. Among the 16 cases of failed reduction, surgical findings were: five cases of ileo-ileo-colic intussusception, one with ileo-ileal, one with perforated ischaemic colon during air enema and one whose intussusception was found to be reduced at surgery. Three patients had lead points: Meckel's diverticula in two and a pinworm in one. Resection was required in three cases for non-viable bowel and in another two for the Meckel's diverticula. Pneumatic reduction of intussusception offers a high success rate with few complications. Performing an air enema earlier in the course of the disease may increase the chance of successful reduction.
authors.affiliation: Department of Diagnostic Radiology, Royal Hospital for Sick Children, Edinburgh.
authors.forename: V G
authors.initials: VG
authors.lastname: McDermott
authors.forename: T
authors.initials: T
authors.lastname: Taylor
authors.forename: S
authors.initials: S
authors.lastname: Mackenzie
authors.forename: G M
authors.initials: GM
authors.lastname: Hendry
mesh_terms: D002675:Child, Preschool; D004733:Enema / Q000009:adverse effects; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications; D006801:Humans; D007077:Ileal Diseases / Q000628:therapy; D007223:Infant; D007327:Insufflation / Q000379:methods*; D007415:Intestinal Obstruction / Q000150:complications; D007421:Intestine, Small; D007443:Intussusception / Q000628:therapy*; D008297:Male; D011312:Pressure; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome