title: Intussusception: postreduction fasting is not necessary to prevent complications and recurrences in the emergency department observation unit.
abstract: OBJECTIVE
  This study aimed to compare the incidence of complications and intussusception recurrences in patients in the pediatric emergency department observation unit (EDOU) who are fed early (< 2 hours) versus late (≥ 2 hours) after radiologic intussusception reduction.
  
  
  METHODS
  This is a retrospective cohort study of children observed in the Texas Children's Hospital EDOU after radiologic intussusception reduction between April 1, 2003, and August 31, 2009. Complications were defined as the postreduction occurrence of intestinal perforation, shock, or sepsis.
  
  
  RESULTS
  There were 149 patients included in the study (median age, 16 months; range, 3-95 months). Oral refeeding was started early in 61 patients (41%) and late in 88 patients (59%). The median length of EDOU stay was 15.6 hours in early refeeders and 16.1 hours in late refeeders (P = 0.58). None of the patients developed any complications. There was no difference in the frequency of postreduction fever, abdominal pain, or vomiting (13% early vs 16% late, P = 0.65); imaging to assess for intussusception recurrence (20% early vs 22% late, P = 0.79); and subsequent hospitalization (3% early vs 8% late, P = 0.31) between the groups. The frequency of intussusception recurrence was higher, but not significantly so (P = 0.31), in the late refeeders (15%) compared with the early refeeders (8%).
  
  
  CONCLUSIONS
  There is no evidence for a difference in complication frequency, intussusception recurrence, or EDOU length of stay between patients who are fed early (< 2 hours) or late (≥ 2 hours) after radiologic intussusception reduction. This indicates that there is no need to withhold feeds from patients after intussusception reduction.
authors.affiliation: Department of Pediatrics, Division of Pediatric Emergency Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA. aoojo@texaschildrenshospital.org
authors.forename: Aderonke Olufikayo
authors.initials: AO
authors.lastname: Adekunle-Ojo
authors.forename: Ann M
authors.initials: AM
authors.lastname: Craig
authors.forename: Long
authors.initials: L
authors.lastname: Ma
authors.forename: Allison Chantal
authors.initials: AC
authors.lastname: Caviness
mesh_terms: D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005215:Fasting; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000601:surgery*; D007223:Infant; D007443:Intussusception / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D011182:Postoperative Care; D012189:Retrospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome