title: Failure of enema reduction for ileocolic intussusception at a referring hospital does not preclude repeat attempts at a children's hospital.
abstract: BACKGROUND
  Some children with intussusception undergo attempted enema reduction at a hospital without pediatric radiology expertise and are transferred to a children's hospital (CH) if this is unsuccessful. We sought to determine whether a failed reduction (FR) at a referring hospital predicted failure of repeated attempts by a pediatric radiologist at a CH.
  
  
  METHODS
  A retrospective review of all children with ileocolic intussusception admitted to a large CH over 9 years was performed. Differences in outcome between those who initially presented to the CH and those who had a FR elsewhere before transfer (FR --> CH) were assessed.
  
  
  RESULTS
  A total of 152 subjects were identified. There was no difference in the frequency of successful enema reduction at the CH for those who initially presented at the CH (60.5%) and those who were transferred after a FR elsewhere (60.7%). The only predictor of successful reduction was anatomy, whereby 64% of intussusceptions proximal to the splenic flexure were reduced, but only 35% of those distal to that point (P < .01).
  
  
  CONCLUSIONS
  Children who are transferred to a CH after failed enema reduction elsewhere should undergo a repeat hydrostatic or pneumatic enema reduction in the absence of other contraindications.
authors.affiliation: Division of Pediatric Surgery, Loma Linda University School of Medicine and Children's Hospital, Loma Linda, CA 92354, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Curtis
authors.forename: Ivan M
authors.initials: IM
authors.lastname: Gutierrez
authors.forename: Shannon R
authors.initials: SR
authors.lastname: Kirk
authors.forename: Gerald
authors.initials: G
authors.lastname: Gollin
mesh_terms: D004733:Enema / Q000379:methods*; D005500:Follow-Up Studies; D006776:Hospitals, Pediatric; D006801:Humans; D007077:Ileal Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D007223:Infant; D007327:Insufflation / Q000379:methods*; D007443:Intussusception / Q000000981:diagnostic imaging / Q000628:therapy*; D010360:Patient Transfer; D011379:Prognosis; D011859:Radiography; D012017:Referral and Consultation; D012189:Retrospective Studies; D017211:Treatment Failure