Sonographic guidance of air enema for intussusception reduction in children

Background. Fluoroscopically guided air reduction of intussusception is a w ell-accepted technique. There are only two previous reports in which US has been used to monitor pneumatic reduction. Objective. To assess the ability of US to monitor the success of air reduct ion of intussusception. Materials and methods. Sonographically guided air-enema reduction of intuss usception in 199 children. In phase I (11 children), the success or failure of reduction was confirmed by fluoroscopy. In phase II (188 children), com plete reduction was confirmed by clinical improvement of the child and repe at sonography 1 h later showing no persistent intussusception. Results. In phase I, fluoroscopy confirmed the accuracy of US in all 11 chi ldren. In phase II, the success rate of initial reduction was 95 %, Followi ng successful reduction, US repeated 1 h later showed no recurrence of intu ssusception in 92%. In ten (5%) of 188, initial reduction was unsuccessful; fluoroscopically guided air reduction successfully reduced only three of t hese ten failures. Conclusions. Air enema guided by US is a practical and reliable technique f or the reduction of intussusception.