Hydrostatic reduction of intussusception: barium, air, or saline?

While there is agreement that hydrostatic reduction (HR) is the ideal first-line treatment for childhood intussusception, there is controversy about which technique is best, namely, barium, air, or saline. We present our experience in the Pediatric Surgical Center, University of Alexandria, in HR of intussusception under ultrasound (US) guidance. The study was divided into two phases: between 1983 and 1990 and between 1991 and 1998. HR was started gradually in phase I, and became routine in phase II. Diagnosis and reduction were done by the pediatric surgical staff. The success rate was 71.7% in phase I and 85.5% in phase II. Most unreduced cases were the ileo-ileocolic type: 58.6% in phase I and 69.3% in phase II. HR under US guidance is equal or superior to other techniques of reduction, while having the obvious advantage of avoiding radiation exposure.