Abstract
We reviewed 645 cases of idiopathic intussusception managed at our institution between May 1983 and December 2005, and explored the risk factors for unsuccessful reduction by a multiple logistic regression analysis. Barium enema reduction under fluoroscopy was replaced by water-soluble gastrografin enema under ultrasound guidance in 2001. A “Rule of Three” (hydrostatic pressure ≤ 3feet, pressuring period ≤ 3 minutes, and number of attempts ≤ 3 times) was the gold standard throughout the study period. The 645 patients ranged in age from 22 days to 93 months, with a median age of 11 months. There were 438 boys and 207 girls, with a male-to-female ratio of 2.1 : 1. Hydrostatic reduction was applied to 635 patients, with a total reduction rate of 83.6%. Perforations occurred in two infants younger than six months old (0.3%). A total of 114 cases (17.7%) underwent surgical reduction. While spontaneous reduction was found in 15 cases (13.2%), necrosis of the intussusceptum was observed in 25 cases (21.9%). Multiple logistic regression analysis revealed three risk factors for unsuccessful reduction; younger age, longer time-course after onset, and a history of unsuccessful reduction before referral.
