Risk Factors of Nonsurgical Management Failure in Pediatric Intussusception Patients With Delayed Presentation.

ABSTRACT

OBJECTIVES: The present study aimed to investigate the time-related predicting factors of the ultrasound-guided hydrostatic reduction (USGHR) failure in pediatric patients with ileocolic intussusception and delayed presentation. METHODS: The present retrospective study included pediatric patients diagnosed with ileocolic intussusception who presented to our hospital with the related symptoms started 48 hours ago or greater duration during 2018-2020. The patients with spontaneous reduction were excluded from the study. Afterward, the participants with failed and successful USGHR were compared in terms of age, sex, symptom duration, and ultrasound findings using the χ 2 and logistic regression tests. RESULTS: A total of 103 children were included in the present study. The mean symptom duration was 4.13 ± 2.39 days, with a range of 2-14 days. Moreover, 47.6% of the patients had a successful reduction. In addition, there was a significant relationship between failed USGHR and the factors of symptom duration, free peritoneal fluid, entrapped fluid between intussuscepted loops, the size of the invaginated segment, and malperfusion of the intussuscepted bowel loops detected using the Doppler ultrasound ( P < 0.05). However, there was no significant relationship between failed USGHR and the factors of the primary location of intussusception and the presence of intussuscepted lymph nodes ( P > 0.05). CONCLUSIONS: The presence of entrapped fluid between the intussuscepted loops, free peritoneal fluid, and the length of the intussuscepted segments were all associated with USGHR failure in our study. Therefore, determining these predictors may help anticipate failure of reduction.