AAP PapersIs it safe to discharge intussusception patients after successful hydrostatic reduction?
Section snippets
Methods
This study was approved by the Children's Hospital of Wisconsin Institutional Review Board (#06/185, GC #246). Medical records of patients 0 to 18 years of age with the diagnosis of intussusception from 1995 to 2006 were reviewed. Asymptomatic patients with incidentally found intussusceptions on axial imaging were excluded if no further intervention for the intussusception occurred. Data collected included age, presenting symptoms and physical examination findings, diagnostic studies, surgical
Results
A total of 309 patients with the diagnosis of intussusception were identified. Of these, 261 (84.5%) patients were admitted to the hospital, including 123 (39.8%) that required surgical intervention and 138 (44.6%) who were admitted to the hospital after successful HR for observation. Of the 138 patients observed as inpatients after successful HR, 73 were admitted to the surgical service and 65 were admitted to a pediatric service. The average length of stay for the patients observed as
Discussion
Intussusception remains a leading cause of acute abdominal pain in young children [4]. Surgical recommendations include in-hospital observation for 48 hours after reduction [1]. Justifications for this include the high risk of recurrence within 48 hours after reduction, possible enema-related complications, and the need for serial abdominal examinations to monitor for segmental ischemia of the intussusceptum. A few studies have found that discharge from the ED after successful HR is safe in
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Intussusception