A review of intussusception cases involving failed pneumatic reduction and re-intussusception.
BACKGROUND
The aim of the present study was to evaluate cases in which intussusception was unsuccessfully treated with pneumatic reduction (PR), and intussusception recurred following PR.


METHODS
The medical records of 401 patients who presented with intussusception between 2003 and 2014 were retrospectively analyzed. Included were 61 patients, 20 of whom underwent unsuccessful PR (Group 1), and 41 of whom experienced intussusception recurrence following PR (Group 2). Treatment and outcome were summarized.


RESULTS
In Group 1 (mean age: 14.2 months; range: 2.5 months-6 years) surgery was indicated due to PR failure in 15 patients, and perforation occurred during PR in 5. In these 5 patients, age was under 1 year (range 6-9 months) and mean time to presentation was 3 days (range 2-4). During laparotomy, pathologies were noted: mesenteric lymphadenopathy (LAP) and/or Peyer's patch hyperplasia was observed in 15 cases, Meckel's diverticulum in 5 cases. In Group 2 (mean age: 20 months; range: 3 months-6 years), intussusception developed after successful PR in 41 patients, most frequently within the first 24 hours (21.51%). Of the 41 patients, recurrent intussusception (RI) was treated with PR in 36, and laparotomy in 5. Operative findings were mesenteric LAP in 4 and polyp in 1.


CONCLUSIONS
PR is effective for the treatment of intussusception and recurrences. Delayed presentation reduces the success rate. In the event of failure, a lead point is usually encountered at laparotomy.
Department of Pediatric Surgery, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul-Turkey. rozcan1@gmail.com.
Rahşan
R
Özcan
Department of Pediatric Surgery, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul-Turkey.
Mirzaman
M
Hüseynov
Department of Pediatric Surgery, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul-Turkey.
Şenol
Ş
Emre
Department of Anesthesiology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul-Turkey.
Çiğdem
Ç
Tütüncü
Department of Biostatistics, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul-Turkey.
Hayriye
H
Ertem Vehid
Department of Pathology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul-Turkey.
Sergülen
S
Dervişoğlu
Department of Radiology, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul-Turkey.
İbrahim
İ
Adaletli
Department of Pediatric Surgery, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul-Turkey.
Sinan
S
Celayir
Department of Pediatric Surgery, İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul-Turkey.
Gonca
G
Tekant
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007443:Intussusception / Q000453:epidemiology* / Q000601:surgery; D007813:Laparotomy; D008297:Male; D008467:Meckel Diverticulum / Q000453:epidemiology* / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology