What's the best Non Surgical method to reduce intussusceptio?

Infographic · May 2021 · 1 min read

In brief

Multi-center study of 2,124 children compared ultrasound-guided saline enema versus fluoroscopy-guided air enema for intussusception reduction. Ultrasound approach achieved higher success rates (95.8% vs 93.1%) without increased perforation risk, while eliminating radiation exposure—particularly effective in 4-24 month age group.

Ultrasound-guided hydrostatic reduction achieved 95.8% success vs 93.1% for fluoroscopy-guided air reduction in 2,124 pediatric cases
UGHR showed superior success rates in children 4-24 months old (95.8% vs 91.6%) without increased perforation risk
Both methods demonstrated comparable safety with perforation rates under 0.4% across all patient groups
UGHR offers radiation-free reduction with higher success in patients presenting 12-24 hours after onset
Recurrence rates were similar between methods (9.3% UGHR vs 10.7% FGAR), suggesting equivalent durability

Written by the GCMD Library team from the infographic.

The infographic uses a split-panel layout with gray icons on white background. Left side shows a simplified human torso with intestinal anatomy highlighted in red, alongside droplet and ultrasound symbols. Right side displays wind symbols and a fluoroscopy screen icon. Below, three outcome metrics are presented with green checkmark for success and gray icons for complications, using large percentage comparisons in black and red text.

Abstract

Background

Intussusception is the most common abdominal emergency in children. The first line treatment of uncomplicated pediatric intussusception is enema reduction. Until now, there have been no multi-center studies comparing the effectiveness and safety of UGHR and FGAR in the treatment of pediatric intussusception. The aim of this study was to compare the effectiveness and safety of the two most commonly used enema methods of pediatric intussusception: ultrasound-guided hydrostatic reduction (UGHR) and fluoroscopy-guided air reduction (FGAR).

Methods

From November 1, 2017 to October 31, 2018, we conducted a multi-center, prospective, cohort study. Children diagnosed with intussusception in four large Children’s Medical Centers in China were divided into UGHR and FGAR groups. Stratified analysis and subgroup analysis were used for further comparison. The success and recurrence rates were used to evaluate the effectiveness of enema reduction. The perforation rate was used to evaluate the safety of enema reduction.

Results

A total of 2124 cases met the inclusion criteria (UGHR group: 1119 cases; FGAR group: 1005 cases). The success and recurrence rates in the UGHR group were higher than in the FGAR group (95.80%, 9.28% vs. 93.13%, 10.65%) (P < 0.05, P > 0.05), respectively. The perforation rate in the UGHR group was 0.36% compared with 0.30% in the FGAR group (P > 0.05). Subgroup analysis showed the success rates in the UGHR group were higher than in the FGAR group of patients with onset time between 12 and 24 h (95.56% vs. 90.57%) (P < 0.05). Of patients aged 4 to 24 months, the success rates in the UGHR group were also higher than in the FGAR group (95.77% vs. 91.60%) (P < 0.05). Stratified analysis showed the success rates in the UGHR group were higher than in the FGAR group in patients with the symptom of bloody stool (91.91% vs 85.38%) (P < 0.05).

Conclusions

UGHR and FGAR are safe, nonsurgical treatment methods for acute pediatric intussusception. UGHR is superior to FGAR, no radiation risk, its success rate is higher, without a difference in perforation rate, especially for patients aged 4–24 months.