Clinical and radiological predictors of the outcome of hydrostatic reduction of primary intussusception in childhood

Abstract

Introduction Success of hydrostatic reduction of intussusception using saline enema could be affected by several factors. Aim This study aimed to detect the clinical and radiological predictors of successful hydrostatic reduction of primary intussusception. Patients and methods This retrospective cross-sectional study included all patients with primary intussusception from the age of 6 months to 3 years. Patients with signs of peritonitis or bowel perforation were excluded from the study. Patients’ age, sex, duration and type of symptoms, general, abdominal, and digital rectal examination findings as well as findings in ultrasound of the abdomen (the presence and the site of an abdominal mass) and plain radiograph (PXR) of the abdomen standing (air fluid levels) were recorded and analyzed by appropriate statistical tools with the software SPSS version 10.0. Results Factors that affected the success of hydrostatic reduction significantly included age at presentation (Student’s t test: 3.46, P=0.001), BMI (Student’s t test: 2.383, P=0.019), long duration of symptoms (Student’s t test: 8.812, P=0.000), passage of red currant jelly stools (χ2-test: 91.777, P=0.000), presence of palpable abdominal mass (χ2-test: 55.813, P=0.000), on the left side of the abdomen (χ2-test: 52.439, P=0.000), and positive findings in PXR abdomen standing (χ2-test: 59.911, P=0.000). Conclusion Primary intussusception in patients with younger age group, low BMI, long duration of symptoms, passage of red currant jelly stool, palpable abdominal mass on the left abdominal side being confirmed by ultrasound of the abdomen, and the presence of air fluid levels in PXR abdomen standing have a lower rate of successful hydrostatic reduction.