Abstract
Introduction Recurrence of ileocolic intussusception (ICI) has been related to residual bowel
wall edema after enema reduction. Early oral tolerance has been associated with a
higher risk of re-intussusception, so an imaging test (ultrasound) has traditionally
been performed before restarting oral tolerance. Our aim is to analyze the cost-effectiveness
of performing a routine ultrasound in patients who remain asymptomatic after successful
enema reduction.
Materials and Methods A retrospective observational study was performed in patients with ICI who underwent
a successful enema reduction between 2005 and 2019 and distributed in two groups according
to whether or not a routine ultrasound was performed before restarting oral tolerance:
group A (ultrasound) or B (no ultrasound). We analyzed demographic, clinical and laboratory
variables, length of hospital stay, and recurrence rate.
Results We included 366 patients who presented 373 ICI episodes (165 in group A and 208 in
group B), without significant differences in gender and age. Group A patients presented
a higher percentage of vomiting and bloody stools than those in group B without differences
in the other clinical features studied, time of evolution, or laboratory variables.
Group A presented a higher length of hospital stay than group B (36 vs. 24 hours),
although it was not statistically significant (p = 0.30). No statistically significant differences were observed in the recurrence
rate between both groups (10.3% A vs. 10.8% B; p = 0.83).
Conclusion Performing routine ultrasound before restarting oral tolerance in asymptomatic patients
after successful ICI reduction does not decrease the risk of re-intussusception and
should not be routinely encouraged.
Keywords
intussusception - children - recurrences - risk factors - food intake
