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Pediatric Radiology

, Volume 45, Issue 5, pp 667–674 | Cite as

Current methods for reducing intussusception: survey results

  • Rebecca Stein-WexlerEmail author
  • Rachel O’Connor
  • Heike Daldrup-Link
  • Sandra L. Wootton-Gorges
Original Article

Abstract

Background

Intussusception is a common pediatric abdominal emergency, treated with image-guided reduction. Available techniques include fluoroscopic and ultrasonographic monitoring of liquid and air.

Objective

The purpose of this study was to determine current practices and establish trends by comparing our findings with reports of previous surveys.

Materials and methods

This study is based on an e-mail survey sent to all 1,538 members of the Society for Pediatric Radiology. It included questions about demographics, presence of parents/surgeon during procedure, patient selection/preparation, use of sedation, preferred methods of reduction and technical details, approach to unsuccessful reduction, and self-reported incidence of success/perforation.

Results

The 456 respondents (30%) reported attempting 3,834 reductions in the preceding 12 months. Of these, 96% use fluoroscopy and 4% use US guidance for reduction; 78% use air, 20% prefer fluid; 75% require intravenous access; 63% expect a surgeon to be present in hospital; 93% do not sedate. Although inflating a rectal balloon is controversial, 39% do so, and 50% employ a pressure-release valve. Seventy-two percent attempt reductions three times in the same position. In case of unsuccessful reductions, 64% wait and re-attempt later, 19% apply manual pressure, and 15% try again in left decubitus position. About 20% reattempt reduction after waiting 2 h or more.

Conclusion

By providing a better understanding of both trends in and diversity of current practice, we hope to increase the confidence with which the individual practitioner will approach each case.

Keywords

Intussusception Intussusception reduction Practice patterns Survey Pediatric 

Notes

Acknowledgments

We would like to acknowledge the assistance of Dr. Mark Lubell, Department of Environmental Science and Policy, University of California, Davis, in developing the survey.

Conflicts of interest

Dr. Stein-Wexler has a small financial interest in Lucy LLC, a company that produces a simulation device for learning intussusception reduction.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Rebecca Stein-Wexler
    • 1
    Email author
  • Rachel O’Connor
    • 2
  • Heike Daldrup-Link
    • 3
  • Sandra L. Wootton-Gorges
    • 1
  1. 1.Department of Radiology Pediatric radiology sectionUniversity of California, Davis Medical CenterSacramentoUSA
  2. 2.Department of RadiologyUniversity of California, Davis, Medical CenterSacramentoUSA
  3. 3.Department of Radiology Pediatric radiology sectionLucile Packard Children’s Hospital, Stanford School of MedicineStanfordUSA

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