Other ConditionManagement of intussusception in children: A systematic review☆,☆☆
Section snippets
Research questions
The American Pediatric Surgical Association (APSA) Outcomes and Evidence-Based Practice (OEBP) committee defined the following topics and questions for this systematic review:
- 1.
Antibiotic use and surgeon availability:
- a.
Should prophylactic antibiotics be given prior to radiological reduction of intussusception?
- b.
If antibiotics are to be given, what spectrum of antibiotics is appropriate?
- c.
Are surgeons required to be present at time of radiographic reduction?
- a.
- 2.
Radiology:
- a.
What clinical parameters allow for
- a.
Prophylactic antibiotics and surgeon availability
Many hospitals caring for children with intussusception have pre-procedural protocols regarding antibiotic use and surgeon availability at time of reduction. Antibiotics may be given prior to an attempt at reduction to treat a transient bacteremia associated with reduction and/or to decrease morbidity associated with bowel perforation during reduction. Presence of a surgeon at time of reduction is thought to facilitate immediate treatment of pneumoperitoneum in case of high-pressure enema
Discussion
Overall, the present literature review on management of intussusception in the pediatric patient highlights opportunities for improved healthcare utilization while maintaining best outcomes. Notably, the data support avoiding antibiotic administration prior to reduction, that repeating attempts at radiologic reduction decrease the need for surgery, safety of discharging patients with radiographically reduced intussusceptions after a period of observation in the ED, and utility of minimally
Funding
Author LIK is supported by grant KL2TR001854 from the National Center for Advancing Translational Science (NCATS) of the U.S. National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
References (64)
- et al.
Antibiotics administration before enema reduction of intussusception: is it necessary?
J Pediatr Surg
(2012) - et al.
Failure of enema reduction for ileocolic intussusception at a referring hospital does not preclude repeat attempts at a children’s hospital
J Pediatr Surg
(2010) - et al.
Current success in the treatment of intussusception in children
Surgery
(2007) - et al.
Hydrostatic reduction of ileocolic intussusception: a second attempt in the operating room with general anesthesia
J Pediatr
(1989) - et al.
Utility of hospital admission after successful enema reduction of ileocolic intussusception
J Pediatr Surg
(2006) - et al.
Hospital admission unnecessary for successful uncomplicated radiographic reduction of pediatric intussusception
Am J Surg
(2017) - et al.
Management of the child after enema-reduced intussusception: hospital or home?
J Emerg Med
(2013) - et al.
Management of childhood intussusception after reduction by enema
Am J Emerg Med
(2011) - et al.
Is it safe to discharge intussusception patients after successful hydrostatic reduction?
J Pediatr Surg
(2010) - et al.
Comparative outcome analysis of the management of pediatric intussusception with or without surgical admission
J. Pediatr. Surg., vol. 49, W.B. Saunders
(2014)
Role of surgery in the era of highly successful air enema reduction of intussusception
Asian J Surg
Laparoscopic versus open reduction of intussusception in children: a single-institution comparative experience
J Pediatr Surg
Laparoscopy in the treatment of intussusception in children
J Pediatr Surg
Laparoscopic vs open surgical approach for intussusception requiring operative intervention
J Pediatr Surg
Idiopathic intussusception: the role of laparoscopy
J Pediatr Surg
Operative treatment for intussusception: should an incidental appendectomy be performed?
J Pediatr Surg
Indications for laparoscopy in the management of intussusception
J Pediatr Surg
Laparoscopic treatment of intussusception
Int J Surg Case Rep
Intussusception in children: evidence-based diagnosis and treatment
Pediatr Radiol
Incidence of intussusception among infants in a large commercially insured population in the United States
Pediatr Infect Dis J
Intussusception in early childhood: a cohort study of 1.7 million children
Pediatrics
Failed intussusception reduction in children: correlation between radiologic, surgical, and pathologic findings
Am J Roentgenol
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement
Open Med
The Oxford 2011 levels of evidence
Oxford Centre Evidence-Based Medicine.
Air enema for reduction of intussusception in children: risk of bacteremia
Radiology
Reducing antibiotic use for young children with intussusception following successful air enema reduction
PLoS One
Intussusception revisited: is immediate on-site surgeon availability at the time of reduction necessary?
Am J Roentgenol
Intestinal intussusception survey about diagnostic and nonsurgical therapeutic procedures
Pediatr Radiol
Pneumatic reduction of intussusception: 5-year experience
Radiology
Air encircling the intussusceptum on air enema for intussusception reduction: an indication for surgery?
Br J Radiol
Intussusception in children: reduction with repeated, delayed air enema
Radiology
Unsuccessful air-enema reduction of intussusception: is a second attempt worthwhile?
Pediatr Surg Int
Cited by (46)
Invagination intestinale aiguë du nourrisson et de l'enfant
2024, Journal de Pediatrie et de PuericultureEffects of sedatives on radiologic enema reduction in children with ileocolic intussusception: A systematic review and meta-analysis
2024, European Journal of Radiology“Inside out” – An exceptional intussusception
2023, Journal of Pediatric Surgery Case ReportsThe infant with rectal bleeding
2023, Paediatrics and Child Health (United Kingdom)Pediatric gastrointestinal and liver disorders
2023, Encyclopedia of Child and Adolescent Health, First EditionThe “Sleeve” teaching method for intussusception anatomy: A pediatric surgeon's experience
2022, Asian Journal of Surgery
- ☆
Financial Disclosure: The authors have no financial relationships relevant to this article to disclose.
- ☆☆
Competing Interests: The authors have no potential competing interests to disclose.