MANUAL REDUCTION WITH THE INDEX FINGER FOR INFANTILE INTUSSUSCEPTION - A MODIFICATION OF HUTCHINSONS MANEUVER

Manual reduction with the index finger (modified Hutchinson's maneuver ) enabling simple and safe manual reduction of infantile intussuscepti on is described. The procedure:was used in four patients, two boys and two girls, ranging in age from 2 to 15 months, as greater than normal compression was necessary and/or serosal splitting occurred during co nventional reduction. The technique is as follows: in addition to the proximal bowel compression with Hutchinson's maneuver, the surgeon ins erts his index finger into the intussusceptum via its neck. The finger enables the surgeon to sound a wider space between the intussusceptum and intussuscipiens, which is most likely to be responsive to bowel c ompression. Although the intussusceptions in the four patients were ca tegorized as ileo-ileo-colic (three cases) and ileo-ileal (one case) t ypes, this manual reduction technique was successful in all cases, no bowel rupture occurred, and hospitalization was no longer than with th e conventional procedure. We conclude that this modified Hutchinson's maneuver may contribute to successful surgical reduction of infantile intussusception.