From
StayCurrentMD
Case-Based Journal Review- Intussusception in 2022
hosted by Dr. Rod Gerardo & Dr. Ellen Encisco & Dr. Todd Ponsky
Part of
Intussusception 8 items
Chapter 1 of 8 · Case-Based Learning
Case & diagnosis
Case presentation and initial diagnostic approach
Expert statements on this page
No expert statements were drawn from this page.
Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
Video
Repeat Enema for Intussusception: Update Course 2016
3 min · Published Aug 2016
Video
Intussusception
Published Mar 2020
Video
Intussusception Guideline
Published Jul 2019
Video
Discharge after Reduction of Intussusception Is Safe and Effective
Published Feb 2019
Video
New Concepts in Radiology: Update Course 2017
40 min · Published Aug 2017
Video
Intussusception - Soft Tissue Abscess - Pilonidal Cyst - Bleeding Meckel's...
19 min · Published Nov 2018
Video
Intestinal Atresia Types Explained: Grossfeld Classification for Pediatric Surgery
1 min · Published Sep 2026
Video
Derivation and validation of the Pediatric Community-Acquired Pneumonia Severity (PedCAPS) score: A prospective cohort study
50 s · Published Sep 2026
Video
FETO for Late-Diagnosed Severe Congenital Diaphragmatic Hernia (CDH) at Cincinnati Children's with Dr. Beth Rymeski
4 min · Published Sep 2026
Video
Severe Congenital Diaphragmatic Hernia (CDH) Case: FETO Management & Unexpected Findings with Dr. Beth Rymeski
3 min · Published Sep 2026
Video
Fetoscopic Endoluminal Tracheal Occlusion (FETO) Procedure: Step-by-Step Guide with Dr. Beth Rymeski
4 min · Published Sep 2026
Video
Choledochal Cyst Types Explained: Pediatric Surgery Fundamentals
1 min · Published Sep 2026
What the experts said
High-volume centers where non-radiologists (surgeons or ED physicians) perform frequent ultrasounds can achieve good diagnostic results for intussusception.
It would be irresponsible for institutions to adopt POCUS for intussusception based solely on this study without adequate training and volume.
The hydrostatic versus air reduction study validates an alternative reduction method showing at least equivalent results.
COVID-era hospital bed and staff scarcity is forcing reconsideration of routine admission practices, and intussusception is an example where evidence supports not admitting by default.
Standard practice in many US institutions is to admit intussusception patients overnight and discharge the next morning, not keep them for 48 hours.
Point-of-care ultrasound for intussusception diagnosis achieved 95% sensitivity and 99% specificity in a 2019 American Journal of Emergency Medicine study.
In resource-limited settings without 24-hour radiology, unnecessary laparotomies are sometimes performed for intussusception diagnosis in the middle of the night.
Ultrasound-guided hydrostatic reduction had 95.8% success rate versus 93.1% for fluoroscopy-guided air reduction in a 2021 World Journal of Emergency Surgery study from China.
The 2% difference in success rates between hydrostatic and air reduction is not clinically significant enough to justify changing established practice.
Obstructive bowel gas pattern on radiograph is associated with decreased air enema success and increased need for surgical bowel resection in a 2020 Pediatric Radiology study.
A 2018 Journal of Pediatric Surgery prediction model using clinical and sonographic data (free fluid, extension beyond splenic flexure, altered Doppler) identified 80% of failed saline enema reductions before the procedure.
Sedation for pneumatic reduction showed slightly better success rate but higher recurrence rate (5.1% vs 1.3%, non-significant) and more perforations (3 vs 0, non-significant) in a 2017 Pediatric Anesthesia study.
S-ketamine sedation versus morphine analgesia showed non-significant differences in success rate (90% vs 70%) and recurrence (10% vs 15%) with no perforations in either group.
If sedation shows no increased perforation risk compared to no sedation, then sedating children for comfort during reduction is justified.
A 2019 JPS systematic review and meta-analysis of 10 studies found no significant difference in ED returns, recurrence, need for operation, or mortality between inpatient and outpatient management after successful air enema reduction.
A 2020 Journal of Pediatric Surgery database study of 8,289 patients found 3.7% readmission and recurrence rate after intussusception reduction.
A 2020 Pediatric Emergency Care study of 200 cases found 13.5% overall recurrence rate with 7.3% recurring within 48 hours, with fever and female sex as risk factors for early recurrence.
Both recent studies show lower recurrence rates (3.7-13.5%) than the traditionally quoted 15-20% that surgeons have been telling families.
Increasing tolerance for recurrence risk benefits the vast majority of children by avoiding unnecessary admission and its associated complications.