Success rate and predictors of failure of enema reduction of intussusception in children with a water-soluble contrast medium at a height of 120 cm or less.

Abstract

Background: This study investigates the reduction rate and failure predictors of hydrostatic enema reduction for intussusception. The procedure typically begins with a water-soluble contrast medium at 90 cm above the patient, subsequently elevated to 120 cm. Our focus is on the reduction rate during initial attempts when the contrast medium is positioned at or below 120 cm from the patient.

Methods: Hydrostatic enema reductions for intussusception, performed between March 2010 and May 2022 at Tokyo Metropolitan Children's Medical Center, were investigated retrospectively. The initial attempts involved one or more trials. The clinical characteristics, treatment modalities, and outcomes were analyzed. Logistic regression was used to identify the predictors of failure when the reduction was performed with the water-soluble contrast medium at a height of 120 cm or less.

Results: Reduction was achieved successfully with the water-soluble contrast medium at a height at or below 120 cm in 77.5% of 351 patients. When reductions performed at heights greater than 120 cm were included, 333 (94.9%) were successful during the initial attempts and were unaccompanied by complications. Predictors of failure of reductions performed at or below 120 cm were age less than 12 months and the presence of trapped fluid.

Conclusion: The present study found a successful reduction rate of 77.5% during the initial attempts, suggesting that a height greater than 120 cm may yield an even greater success rate. Children aged below 12 months and those with trapped fluid may have a greater failure risk during the initial attempts.