Air enema for diagnosis and reduction of intussusception in children: Clinical experience and fluoroscopy time correlation

Purpose: The objective of this study was to correlate the fluoroscopy time with radiologic outcome in the pneumoreduction of intussusception in childr en. Methods: From September 1995 to December 1997, a prospective analysis of 18 1 cases of pediatric intussusception with pneumoreduction without sedation was done. A receiver operating characteristic curve of fluoroscopy time was drawn for correlation with radiologic outcome. Results: The overall success and failure rates of pneumoreduction were 84% and 16%, respectively. Three patients (1.6%) experienced colon perforation. The mean fluoroscopy time was 2.8 +/- 1.7 minutes in successful procedure and 4.9 +/- 2.8 minutes in failed procedures (P < 0.001). Analysis of the r eceiver operating characteristic curve of fluoroscopy time indicates that 4 minutes fluoroscopy time was a good critical point in differentiating succ essful and failed cases. In those 18 patients who had successful reduction with fluoroscopy times of more than 4 minutes, 4 patients had clinical symp toms for more than 1 day and 24 patients less than 1 day. One of those 4 pa tients required operation 1 day later because of peritonitis caused by necr osis of terminal ileum. Two patients had high fever in the next 2 days and recovered after antibiotic treatment. Conclusions: Pneumoreduction is a good method in treatment of intussuscepti on with high successful rate. Four minutes is the critical point of procedu re. Reduction with greater than 4 minutes in those patients having illness more than 1 day might not benefit and have more complications. J Pediatr Su rg 36:479-481. Copyright (C) 2001 by W.B. Saunders Company.