Ultrasonography-guided hydrostatic reduction of ileocolic intussusception in childhood: First-line option for management of primary and recurrent cases

To evaluate the results of ultrasonography-guided hydrostatic reduction in primary and recurrent ileo-colic intussusception in children.The children (18 years of age) who were managed for ileocolic intussusception between January 2015 and December 2018 were evaluated retrospectively. Age, gender, presenting complaints, length of the intussuscepted segment, presence of leading point, treatment modalities, recurrence rates and duration of recurrence were evaluated.108 patients with ileocolic intussusception were enrolled in the study; 59 were male and 49 were female with a mean age of 2.04 ± 1.71 years. Two patients underwent immediate surgery without any attempt of hydrostatic reduction. Nineteen patients (18%) were managed by conservative measures initially. Seventeen (89.5%) of them have recovered with expectant management and two patients required hydrostatic enema reduction during follow-up. In total, 89 patients underwent hydrostatic reduction; 48 were male and 41were female with a mean age of 1.9 ± 1.65 years. Twelve patients (13.5%) received surgery after failed hydrostatic reduction. In the patients with successful hydrostatic reduction, one more episode of intussusception is seen in 10 patients (13%) and 2 additional episodes in 2 (2.6%). Seven patients with relapse were male and 5 were female with a mean age of 1.16 ± 1.64 years. The median duration of the first relapse episode was 67.5 days (range;18-110 days). The ultrasound-guided hydrostatic reduction was also successful in patients with recurrence.Ultrasound-guided hydrostatic reduction is a non-invasive treatment of ileocolic intussusception with high success rates in childhood. It can be performed safely in both initial and relapse episodes of intussusception.