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Intussusception in Children: US-guided Pneumatic Reduction—Initial Experience¹

¹ From the Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-dong, Songpa-ku, Seoul 138-736, South Korea. From the 1999 RSNA scientific assembly. Received March 13, 2000; revision requested April 26; revision received June 14; accepted July 11. Address correspondence to C.H.Y. (e-mail: chyoon@www.amc.seoul.kr).

PURPOSE: To assess the feasibility and effectiveness of ultrasonography (US)-guided pneumatic reduction of intussusception in children.

MATERIALS AND METHODS: The study group consisted of 49 consecutive patients (aged 2 months to 7 years; 36 boys, 13 girls) who underwent 52 reductions of intussusception during 9 months. Intussusception was diagnosed in all patients with the known US criteria, and all patients underwent a US-guided pneumatic reduction attempt wholly within the US examination room. A pressure of 60 mm Hg was maintained for 30 seconds, with US guidance. The procedure was considered to be successful when US showed the disappearance of the intussusceptum and the edematous terminal ileum with an abrupt transition into the normal proximal ileum. When the intussusception was not reduced, the procedure was repeated, with pressure increased to 120 mm Hg.

RESULTS: The overall success rate of US-guided pneumatic reduction was 92% (48 of 52 reductions), with no immediate recurrence. Of the two patients who had intussusceptions that were unreducible, one had residual ileoileal intussusception at surgery, and the other had an ileal polyp as a lead point. Perforation occurred in two (4%) of 52 cases; one patient underwent right hemicolectomy due to bowel necrosis and had a pinpoint perforation in the normal proximal transverse colon, and the other underwent manual reduction of ileoileocolic intussusception, with microperforation in the proximal transverse colon.

CONCLUSION: US-guided pneumatic reduction seems to be a feasible and effective method for the treatment of intussusception in children because of its radiation-sparing effect and high success rate.

Index terms: Gastrointestinal tract, interventional procedures, 70.1269 • Interventional procedures, in infants and children, 70.1269 • Intussusception, 70.73 • Ultrasound (US), guidance, 70.12986

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