2019 Volume 55 Issue 1 Pages 53-58
Purpose: Therapeutic hydrostatic enema under ultrasound is used to treat intussusception. A height of 120 cm is recommended in the Japanese guideline for the management of intussusception in children. It is well known that intestinal perforation in enema reduction occurs in patients under 6 months of age. However, it is uncertain whether we need to maintain a height of 120 cm even in the above-mentioned patients. We investigated the results of the hydrostatic reduction and evaluated the data of age and height for completing the enema reduction safely.
Methods: The cases of 50 patients who experienced recurrent intussusception 53 times and were treated in our institution between 2011 and 2016 were reviewed. A saline solution was used for enema reduction. It was started from a height of 100 cm with the advanced part of the intussusception checked by ultrasound, and the height was increased up to 180 cm unless a hydrostatic solution goes through the ileocecal valve.
Results: Intussusception was successfully reduced in 50 of the 53 patients (94.3%), and it recurred in 3 the 53 patients (6.0%). All 3 patients underwent the second enema reduction safely. No complication occurred at a height under 150 cm. In seven patients, 160 cm or more was needed for enema reduction. The significant cutoff age for enema reduction was 1.16 years. The reduction rates were 69.4% for patients less than 1.16 years of age and 99.7% for those older and for enema at a height below 150 cm.
Conclusions: It would be safe to set a height of 120 cm for patients below 1.16 years of age and 150 cm for older patients.
