Patient Characteristics Associated With Spontaneous Reduction Of Intussusception In Children
*Alexis Bowder, *Kimberly Somers, *Sabina Siddiqui
Children's Hospital of Wisconsin, Milwaukee, WI
OBJECTIVE(S): Management of intussusception varies widely between healthcare centers. The treatment modality is highly debated, even if intervention is indicated. Our study aimed to identify the cohort of patients who experience spontaneous reduction of intussusception (SROI) and may not require radiographic or surgical intervention.
METHODS: We performed an IRB-approved retrospective study of all patients with a diagnosis of intussusception from 2013 to 2018 at a Level I Children's Hospital Surgery Center. Data obtained included demographics, presenting symptoms, imaging modality, need for reduction, radiologic reduction approach and number of attempts, and need for surgical reduction
RESULTS: Two hundred and eighty-one patients were identified. The median age of our patients was 1.8 years (95% CI 1.45, 2.15) and 32% were male. Thirty two percent of the patients were transferred from an outside facility, of which a majority were transported by primarily by private car (n= 224, 80%). Over half (52%) of our patients presented with symptom duration of < 24 hours. The most common imaging modality used to diagnose intussusception was ultrasound. Less than one fifth, 52 patients (19%) required surgical intervention to reduce their intussusception. Forty-four patients (16%) had spontaneous reduction of their intussusception. Patients presenting with small bowel intussusception (81%) were more likely to have spontaneous reduction of their intussusception (p=<0.0001). However, spontaneous reduction was also documented in patients who had ileocolic (17%) and colonic (2%) intussusception. The presence of bloody stools was the only symptom in our study that indicated potential statistical significance for requiring a radiological or surgical intervention.
CONCLUSIONS: Among patients who present with intussusception, there is a high rate of spontaneous reduction. This implies that certain children may be safely observed without radiographic or surgical intervention. Further delineating this patient population can help optimize health care service utilization including transport, admission, and length of stay.
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