PNEUMATIC REDUCTION OF INTUSSUSCEPTION - CLINICAL-EXPERIENCE AND FACTORS AFFECTING OUTCOME

Between 1987 and 1992, 54 patients (32 male, 22 female) underwent 62 a ttempts at pneumatic reduction of intussusception. The mean age at pre sentation was 12.5 months (range 2.5 to 4 years 4 months). A retrospec tive review of all cases was performed to identify success rate and fa ctors affecting it. Successful reduction was achieved in 46 cases (74% ). One case was complicated by perforation and four cases (7%) by earl y recurrence. Patients with failed pneumatic reduction were more likel y than those with successful reduction to have: (1) long duration of s ymptoms; (2) bleeding per rectum; (3) small bowel obstruction. Among t he 16 cases of failed reduction, surgical findings were: five cases of ileo-ileo-colic intussusception, one with ileo-ileal, one with perfor ated ischaemic colon during air enema and one whose intussusception wa s found to be reduced at surgery. Three patients had lead points: Meck el's diverticula in two and a pinworm in one. Resection was required i n three cases for non-viable bowel and in another two for the Meckel's diverticula. Pneumatic reduction of intussusception offers a high suc cess rate with few complications. Performing an air enema earlier in t he course of the disease may increase the chance of successful reducti on.