Hydrostatic reduction of intussusception: the impact of high enema pressure on success rates
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In brief
In brief
This retrospective study of 531 intussusception cases demonstrates that higher hydrostatic enema pressure (130 mmHg) achieves superior reduction success rates (99.2% vs 94.8%) without increasing perforation risk or recurrence. The findings support optimized pressure protocols for non-operative intussusception management in pediatric patients.
- Hydrostatic reduction at 130 mmHg achieved 99.2% success rate vs 94.8% at lower pressure (P=0.004), demonstrating superior efficacy.
- Higher enema pressure (130 mmHg) showed no increased perforation risk or complications in 531 intussusception cases over 4 years.
- Recurrence rates were similar between pressure groups: 9.4% vs 7.1% within 48h, 6.5% vs 6.7% beyond 48h (P=0.526).
- Overall intussusception reduction success rate of 97% supports hydrostatic enema as first-line non-surgical intervention.
- Optimizing enema pressure to 130 mmHg may reduce need for repeat procedures or surgical intervention without added safety concerns.
Written by the GCMD Library team from the article.
Abstract
Purpose
The aim of this study is to analyze the effect of increasing enema pressure on enema outcomes.
Methods
We conducted a retrospective study to compare the effect of increasing enema pressure on enema outcomes. The primary outcome was the success rate of reduction, while secondary outcomes included intestinal perforation and recurrence rate.
Results
From May 2017 to April 2021, a total of 531 intussusceptions in 499 patients (Group A 247 patients, Group B 252 patients) were collected. The overall success reduction rate was 97.00%. The success reduction rate in Group A was 99.20% (245/247) and 94.8% (239/252) in Group B (P = 0.004). The overall recurrence rate within 48 h after the initial enema reduction was 8.02%, and beyond 48 h was 6.41%. The recurrence rates within 48 h and beyond 48 h were 9.39% and 6.53% in group A and 7.11% and 6.69% in group B, respectively (P = 0.526). No complications were associated with the enema reduction procedure.
Conclusion
Our study has shown that using a hydrostatic pressure of 130 mmHg for enema reduction is both effective and safe, with a higher success rate and no increased risk of complications.
Level of evidence
Therapeutic study, III.