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Pediatr Emerg Care. 2018 Jul;34(7):484-487. doi: 10.1097/PEC.0000000000001071.

Risk Factors for Recurrent Intussusception After Fluoroscopy-Guided Air Enema.

Author information

1
From the Departments of Pediatrics and.
2
Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Abstract

OBJECTIVES:

The aim of this study was to identify risk factors for recurrent intussusception after a successful reduction by fluoroscopy-guided air enema, the time required for recurrence, and the association between delayed reduction and the recurrence.

METHODS:

Medical records of 479 consecutive children with intussusception who underwent fluoroscopy-guided air enema between January 2004 and September 2014 were reviewed. Recurrent intussusception was defined as a recurrence within 48 hours of a reduction. Symptom-to-door time was defined as the time from symptom onset to emergency department arrival. Door-to-reduction time was defined as the time from emergency department arrival to reduction. Time-to-recurrence was defined as the time required for recurrence from the first ultrasound diagnosis.

RESULTS:

Of the 360 eligible children, 32 had recurrent intussusceptions (8.9%). Multivariable logistic regression showed that age 2 years or older is an independent predictor of recurrent intussusception (odds ratio, 2.39; 95% confidence interval, 1.13-5.02; P = 0.02). Median time to recurrence was 25 hours (18.0-36.0 hours). Although symptom-to-door and door-to-reduction times tended to be longer in the recurrence group, these differences were not significant (12.5 vs 7.0 hours, P = 0.18; 154.0 vs 143.0 minutes, P = 0.67, respectively).

CONCLUSIONS:

Our data suggest that provision for early recurrence and extended observation may be beneficial for children 2 years or older. Delayed reduction was not associated with recurrent intussusception, but further studies with larger sample sizes are needed to explain this issue.

PMID:
28221279
DOI:
10.1097/PEC.0000000000001071
[Indexed for MEDLINE]

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