Can intussusceptions of small bowel and colon be transient? A prospective study

Eur J Pediatr. 2019 Oct;178(10):1537-1544. doi: 10.1007/s00431-019-03455-z. Epub 2019 Aug 24.

Abstract

We performed a prospective study to explore a diagnosis and treatment protocol of transient intussusception in children (TIC). Totally, 143 children with intussusception who met the inclusion criteria were firstly divided into intussusception involving only the small bowel and intussusception involving the colon group. And in each group, they were further divided into short-segment (≤ 3.0 cm) and long-segment (> 3.0 cm) groups according to the length of intussusception. After a period of conservative treatment, the incidence of TIC, the incidence of surgery, and recurrence were collected and analyzed. Finally, we found that the incidence of TIC in the short-segment group of small bowel intussusception (96.29%) was significantly higher than that in other groups (P ≤ 0.001). Besides, the incidence of surgery and recurrence in this group was relatively low too. Therefore, we summarized the inclusion criteria and treatments to the short-segment group of small bowel intussusception as the suggested protocol to TIC.Conclusion: For cases of small bowel intussusception with no identified pathologic lead point, a short duration of symptoms, a length of ≤ 3.0 cm, a relatively abundant vascular flow signal, and a stable general condition, the spontaneous reduction could be expected and a period of conservative treatment with careful monitoring is recommended. What is Known: • The phenomenon of spontaneous reduction in intussusception (transient intussusception) among pediatric patients has been widely reported. • To distinguish the transient intussusception from the other types is important for the transient ones only need conservative treatment rather than enema reduction or surgery. What is New: • This is the first prospective study to explore a diagnosis and treatment protocol of transient intussusception in children. • Short-segment small bowel intussusceptions have a higher rate (96.29%) to get spontaneous reduction than the other types of intussusception.

Keywords: Children; Intussusception; Spontaneous reduction; Transient intussusception; Ultrasound.

MeSH terms

  • Child, Preschool
  • Colonic Diseases / therapy*
  • Conservative Treatment / methods*
  • Enema / adverse effects
  • Female
  • Humans
  • Infant
  • Intestine, Small*
  • Intussusception / diagnostic imaging
  • Intussusception / therapy*
  • Male
  • Prospective Studies
  • Remission, Spontaneous
  • Ultrasonography