Sonographic guidance of air enema for intussusception reduction in children

Abstract

Background. Fluoroscopically guided air reduction of intussusception is a well-accepted technique. There are only two previous reports in which US has been used to monitor pneumatic reduction. Objective. To assess the ability of US to monitor the success of air reduction of intussusception. Materials and methods. Sonographically guided air-enema reduction of intussusception in 199 children. In phase I (11 children), the success or failure of reduction was confirmed by fluoroscopy. In phase II (188 children), complete reduction was confirmed by clinical improvement of the child and repeat sonography 1 h later showing no persistent intussusception. Results. In phase I, fluoroscopy confirmed the accuracy of US in all 11 children. In phase II, the success rate of initial reduction was 95 %. Following successful reduction, US repeated 1 h later showed no recurrence of intussusception in 92 %. In ten (5 %) of 188, initial reduction was unsuccessful; fluoroscopically guided air reduction successfully reduced only three of these ten failures. Conclusions. Air enema guided by US is a practical and reliable technique for the reduction of intussusception.