title: Is every intussusception treatment an emergency intervention or surgery?
abstract: BACKGROUND
  Intussusception is the second most common cause of acute abdomen in children, following appendicitis. The aim of the present study was to evaluate the experience of the authors, in an effort to promote intussusception management, especially that of small bowel intussusception.
  
  
  METHODS
  Records of intussusception diagnosed between July 2002 and September 2014 were evaluated in terms of patient age, sex, clinical findings, admission time, ultrasonographic findings, treatment methods, and outcomes.
  
  
  RESULTS
  Eighty-one patients, 52 males and 29 females, were included (mean age: 10.6 months). Intussusceptions were ileocolic (IC) in 52 cases, ileoileal (IL) in 26, and jejunojejunal (JJ) in 3. Nineteen (23.5%) patients underwent surgery. Hydrostatic reduction was performed in 45 (55.5%) IC cases. Seventeen (21%) patients with small bowel intussusceptions (SBIs), measuring 1.8-2.3 cm in length, spontaneously reduced. All patients who underwent surgery had intussusceptums ≥4 cm. Three of the 4 intestinal resection cases had history of abdominal surgery.
  
  
  CONCLUSIONS
  If peritoneal irritation is present, patients with intussusception must undergo surgery. Otherwise, in patients with IC intussusception and no sign of peritoneal irritation, hydrostatic or pneumatic reduction is indicated. When this fails, surgery is the next step. SBIs free of peritoneal irritation and shorter than 2.3 cm tend to spontaneously reduce. For those longer than 4 cm, particularly in patients with history of abdominal surgery, spontaneous reduction is unlikely.
authors.affiliation: Department of Pediatric Surgery, Başkent University Faculty of Medicine, Ankara-Turkey. dr.guney@gmail.com.
authors.forename: Lütfi Hakan
authors.initials: LH
authors.lastname: Güney
authors.affiliation: Department of Pediatric Surgery, Başkent University Faculty of Medicine, Ankara-Turkey.
authors.forename: Ender
authors.initials: E
authors.lastname: Fakıoğlu
authors.affiliation: Department of Pediatric Surgery, Başkent University Faculty of Medicine, Ankara-Turkey.
authors.forename: Tuğba
authors.initials: T
authors.lastname: Acer
authors.affiliation: Department of Pediatric Surgery, Başkent University Faculty of Medicine, Ankara-Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Ötgün
authors.affiliation: Department of Pediatric Surgery, Başkent University Faculty of Medicine, Ankara-Turkey.
authors.forename: Esra Elif
authors.initials: EE
authors.lastname: Arslan
authors.affiliation: Department of Pediatric Surgery, Başkent University Faculty of Medicine, Ankara-Turkey.
authors.forename: Müge
authors.initials: M
authors.lastname: Sağnak Akıllı
authors.affiliation: Department of Pediatric Surgery, Başkent University Faculty of Medicine, Ankara-Turkey.
authors.forename: Akgün
authors.initials: A
authors.lastname: Hiçsönmez
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D007223:Infant; D007231:Infant, Newborn; D007443:Intussusception / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D007579:Jejunal Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology