Effects of General Anesthesia on the Success Rate of Pneumatic Reduction in the Treatment of Intussusception.

BACKGROUND

Intussusception is one of the most frequent reasons for intestinal obstruction in young children, which needs to be treated immediately. When it comes to non-operative reduction, there is no gold standard. Our goal was to look into how general anesthesia affected the success rate of pneumatically reduced intussusception guided by fluoroscopy.

METHODS

This prospective study was done throughout the time between January 2023 and January 2024 by collaboration between the Pediatric Surgery Unit and Diagnostic Radiology Departments, Al-Azhar University Hospital, New Damietta, Egypt. Under general anesthesia, pneumatic reduction guided by fluoroscopy was performed on all intussusception patients. Children with pathologic lead points discovered by ultrasonography, those with symptoms of intestinal perforation or peritonitis, and those who were hemodynamically unstable were excluded. Statistical analysis of the obtained data was done using the SPSS program (version 20).

RESULTS

In all, 34 children between the ages of 3-28 months, pneumatic reduction under general anesthesia was successful in 32 individuals (94.1% overall). On the first trial, the intussusception was succeeded in 26 patients; on the second try, it was reduced in 5 patients, and in the third, in 1 patient. In two cases, the intussusception failed after three successive trials. One of them was diagnosed as an extended intussusception mass, which was later surgically confirmed, and the other was an appendico-cecal intussusception. During the reduction efforts, there was no bowel perforation or death reported.

CONCLUSION

As a first-line therapy for pediatric intussusception, fluoroscopy-guided PR under GA is straightforward, risk-free, and successful, with no complications or mortalities.