Intussusception in infants and children: feasibility of ambulatory management

To evaluate the ambulatory management of ileo-colic intussusception in infa nts and children, a retrospective study over 3 years of 113 children treate d for ileo-colic intussusception ill a paediatric emergency department was undertaken with the aim of shortening the length of stay. A total of 113 ch ildren aged 10 days to 9 years (median 12 months) were treated for intussus ception between January 1993 and December 1996. None had septic shock or pe ritoneal aeric effusion. Barium enema reduction was attempted in all patien ts. Successful reduction rate was 81%. Fifty patients (44.2%) were complete ly ambulatory managed and 42 were hospital-supervised after successful enem a reduction. Twenty-one children underwent laparotomy after failure of enem a. With the ambulatory device, costs were reduced ($1000/case) compared wit h conventional in-patient treatment. Conclusion Outpatient treatment of acute ileo-colic intussusception is secu re and reduces costs. It depends on the willingness of the medical team but requires simultaneous adaptation of hospital funding to promote this trend .