title: Intussusception clinical pathway: a survey of pediatric surgery practices.
abstract: Therapeutic reduction of intussusception by air or contrast enema may require surgery if the bowel is irreducible or perforates. There is no standard for the involvement of a pediatric surgeon in the workup of the condition. A regional survey of clinical practices was therefore undertaken to attempt to establish a consensus as to when the presence of a pediatric surgeon is required. Distributed to pediatric surgeons at 32 institutions, a questionnaire asked the process of imaging and reduction of infants with intussusception and the extent of pediatric surgical involvement. Surgeons at 29 institutions responded (91%). Ultrasound was used in diagnosis in 16 (55%), 13 (45%) requiring a positive ultrasound diagnosis of intussusception before attempting reduction. Three-fourths (22 [76%]) required surgeon notification that enema reduction was taking place, and one-fourth (seven [24%]) required prior surgical consultation. Only three (10%) required the presence of a surgery team member. Most (21 [72%]) did not demand one, and five (18%) indicated that surgical presence was desirable but not a necessity. There is no consensus for pediatric surgical involvement before and during reduction of an intussusception.
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, University of Kentucky, Lexington, Kentucky, USA.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Stokes
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Iocono
authors.forename: Samuel
authors.initials: S
authors.lastname: Brown
authors.forename: John M
authors.initials: JM
authors.lastname: Draus
mesh_terms: D019091:Critical Pathways / Q000706:statistics & numerical data*; D004733:Enema / Q000706:statistics & numerical data; D006801:Humans; D007077:Ileal Diseases / Q000601:surgery; D007223:Infant; D007443:Intussusception / Q000175:diagnosis* / Q000628:therapy*; D010372:Pediatrics / Q000706:statistics & numerical data*; D011159:Population Surveillance; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015144:Southeastern United States / Q000453:epidemiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome