Intussusception: The accuracy of ultrasound-guided saline enema and the usefulness of a delayed attempt at reduction

Background/Purpose: The aim of this study was to evaluate the therapeutic v alue of ultrasound (US)-guided saline enema for intussusception and the use fulness of a delayed attempt after at least 30 minutes when reduction has n ot been complete. Methods: One hundred ninety-five cases elf intussusception were diagnosed w ith ultrasonography. US-guided saline hydrostatic reduction was performed i n 194 with an additional attempt after at least 30 minutes in those cases i n which only partial resolution had been achieved. The method was changed ( the volume of the reservoir bag and the caliber of the catheter were increa sed) so we analyze two different periods; 85 cases are included in the firs t period and 110 in the second. Results: The global rate of successful reduction was 81.9% (159 of 194 case s), and it raised to 88.2% (97 of 110 cases) in the second period. In 15.5% cases (30 of 194) reduction was achieved in a delayed attempt at least 30 minutes after the initial partial resolution. The rate of recurrence was 9. 7%. No perforation was seen. Conclusions: The accuracy of US-guided saline enema in achieving intussusce ption reduction is high, similar to other methods, avoiding radiation expos ure. A delayed attempt after a period of rest increases the rate of reducti ons. J Pediatr Surg 34:1016-1020. Copyright (C) 1999 by W.B. Saunders Compa ny.