Purpose
Intussusception is one of the most common causes of intestinal obstruction in children under the age of 2 years, especially in male. In this study, we compared the results of pressure reductions for various treatment methods and identified the
factors
related to reduction failure. Methods
From Jan. 1996 to Dec. 1997, 87 barium reductions and 127 air reductions were performed for childhood intussusception. Success rates of these non-operative managements and factors affecting those rates were analyzed. Results
1) When only ileocolic intussusceptions were considered in order to exclude the effect of different type of intussusceptions, the success rate for air reduction (AR) was 83.5%, which was significantly higher than 71.8% in barium reduction (BR).
2)
Factors affecting reduction failure were history of preceding upper respiratory infection, fever (≥38oC) and symptom duration in BR, and abdomina l distension, leukocytosis (≥10,000/mm3), and symptom duration in AR. 3)
Bowel
perforations were occurred in 3 cases of AR, but all of these cases showed bowel wall infarction requiring bowel resection, and complications due to perforations were minimal. There were no BR-related complications in BR. 4) Intussuception
recurred
in
7.4% of all cases; 4.9% after BR, 9.3% after AR. The mean intervals between previous reduction and recurrence were 37.0 (range 1∼88) days in BR and 64.3 (range 2∼283) days in AR. Recurrences occurred within 48 hours after reduction in 2 cases
of
BR
and in 3 cases of AR. Conclusion
Compared with conventional barium reduction, air reduction had a relatively higher success rate in managing childhood intussusception, in spite of a slightly higher risk of bowel perforation. However, perforation did not significantly affect the
clinical course. Therefore, air reduction is one of the good alternative of conventional barium reduction for managing childhood intussusception.
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