Eur J Pediatr Surg 2021; 31(01): 115-119
DOI: 10.1055/s-0040-1719055
Original Article

Routine Ultrasound Control after Successful Intussusception Reduction in Children: Is It Really Necessary?

1  Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain
,
Antonella García
2  Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
,
Bonifacio Delgado
3  Department of Mathematics, Complutense University of Madrid, Madrid, Comunidad de Madrid, Spain
,
1  Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain
,
Miriam Miguel-Ferrero
1  Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain
,
Saturnino Barrena
1  Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain
,
Manuel Lopez Santamaria
1  Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain
,
Leopoldo Martinez
1  Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain
› Author Affiliations

Abstract

Introduction Recurrence of ileocolic intussusception (ICI) has been related to residual bowel wall edema after enema reduction. Early oral tolerance has been associated with a higher risk of re-intussusception, so an imaging test (ultrasound) has traditionally been performed before restarting oral tolerance. Our aim is to analyze the cost-effectiveness of performing a routine ultrasound in patients who remain asymptomatic after successful enema reduction.

Materials and Methods A retrospective observational study was performed in patients with ICI who underwent a successful enema reduction between 2005 and 2019 and distributed in two groups according to whether or not a routine ultrasound was performed before restarting oral tolerance: group A (ultrasound) or B (no ultrasound). We analyzed demographic, clinical and laboratory variables, length of hospital stay, and recurrence rate.

Results We included 366 patients who presented 373 ICI episodes (165 in group A and 208 in group B), without significant differences in gender and age. Group A patients presented a higher percentage of vomiting and bloody stools than those in group B without differences in the other clinical features studied, time of evolution, or laboratory variables. Group A presented a higher length of hospital stay than group B (36 vs. 24 hours), although it was not statistically significant (p = 0.30). No statistically significant differences were observed in the recurrence rate between both groups (10.3% A vs. 10.8% B; p = 0.83).

Conclusion Performing routine ultrasound before restarting oral tolerance in asymptomatic patients after successful ICI reduction does not decrease the risk of re-intussusception and should not be routinely encouraged.



Publication History

Received: 15 May 2020

Accepted: 21 September 2020

Publication Date:
29 October 2020 (online)

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