Hydrostatic reduction of ileocolic intussusception: a second attempt in the operating room with general anesthesia

Intussusception, the inverse telescoping of the bowel into itself, can cause blockage in infants and children. Enemas given to create pressure in the intestines from the force of the fluid being flushed into the rectum can sometimes relieve ileocolic (between the ileum and the colon) intussusception in the bowel. In cases where initial manipulation of the bowel by enema fails, the use of anesthesia during second enema attempt may prove useful. Over a three-year period, enemas were performed in 62 children. In 31 children of those children a first attempt was unsuccessful. A second try performed in the operating room with the use of anesthesia was successful in 21 children. Manipulation of the bowel during surgery had to be performed in the remaining 10 children. Two children required surgical resection of the bowel. Surgery was avoided in 84 percent of the affected children over the three years. It is suggested that the anesthesia used during the second attempt caused the walls of the intestines to relax during the enemas. The relaxation and the time delay between the two attempts may have contributed to the success of the second attempt. It is concluded that the use of anesthesia during a second attempt for intussusception repair should be included in the standard treatment of ileocolic intussusception in children.