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Am J Surg. 2017 Dec;214(6):1203-1207. doi: 10.1016/j.amjsurg.2017.08.040. Epub 2017 Sep 20.

Hospital admission unnecessary for successful uncomplicated radiographic reduction of pediatric intussusception.

Author information

1
Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: mmallicote@chla.usc.edu.
2
Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: misani@chla.usc.edu.
3
Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: anne.s.roberts@gunet.georgetown.edu.
4
Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: nicoleej@usc.edu.
5
Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: kabowen@utmb.edu.
6
Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: riburke@chla.usc.edu.
7
Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: jstein@chla.usc.edu.
8
Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: cgayer@chla.usc.edu.

Abstract

PURPOSE:

After radiologic reduction, patients with ileocolic intussusception are often admitted. We hypothesize that discharge of stable patients after 4 h of emergency department (ED) observation does not result in an increase of adverse outcomes.

METHODS:

We retrospectively reviewed pediatric patients with ileocolic intussusception between 2011 and 2016, managed with either 24-h inpatient or 4-h ED observation. Outcomes included length of stay, adverse outcomes, and total hospital charges.

RESULTS:

Fifty-one patients were managed with ED observation and 79 with inpatient observation. Recurrence rates, time to recurrence, and adverse outcomes were similar in both protocols. Total recurrence rates for ED observation was 15% versus 14% for inpatient observation. ED observation reduced time in the hospital by 26.8 h (4.9 versus 31.7 h).

CONCLUSION:

Discharging patients following uncomplicated hydrostatic reduction of ileocolic intussusception after a 4-h observation period does not result in an increase in adverse outcomes.

KEYWORDS:

Ileocolic; Intussusception; Observation; Pediatric; Reduction

PMID:
28969892
DOI:
10.1016/j.amjsurg.2017.08.040
[Indexed for MEDLINE]

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