Faculty Collaboration Database

Is it safe to discharge intussusception patients after successful hydrostatic reduction? J Pediatr Surg 2010 Jun;45(6):1182-6

Date

07/14/2010

Pubmed ID

20620317

DOI

10.1016/j.jpedsurg.2010.02.085

Scopus ID

2-s2.0-77953854009 (requires institutional sign-in at Scopus site)   35 Citations

Abstract

PURPOSE: The aim of this study was to evaluate whether discharge from the emergency department (ED) after successful hydrostatic reduction (HR) of intussusception is safe.

METHODS: We conducted a single institution review of patient records with a diagnosis code of intussusception from 1995 to 2006. Data collected included age, clinical presentation, imaging, surgical interventions, pathology, recurrence, and disposition. Statistical analysis utilized chi(2) tests, where P < or = .05 was considered significant.

RESULTS: A total of 309 patients with intussusception were identified. One hundred twenty-three patients (39.8%) required surgical intervention, 138 (44.6%) patients were managed nonoperatively as inpatients, and 48 (15.5%) were treated nonoperatively and discharged from the ED. There were 18 recurrences (5.8%). Recurrence rates did not significantly differ between patients who required operative reduction and those who were managed nonoperatively with HR and either observed as inpatients or discharged from the ED. Seven patients with recurrences required surgical intervention, and 1 of those children had a pathologic lead point, which was nonneoplastic.

CONCLUSIONS: Recurrence rates do not differ between children observed as inpatients and those discharged home after successful HR. Missed neoplastic pathologic lead points were not found in the patients who required an operation after a recurrence. Our data suggests that it is safe to discharge patients selectively from the ED after successful HR.

Author List

Whitehouse JS, Gourlay DM, Winthrop AL, Cassidy LD, Arca MJ

Authors

Laura Cassidy PhD Associate Dean, Director, Professor in the Institute for Health and Humanity department at Medical College of Wisconsin
David M. Gourlay MD Chief, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Child
Child, Preschool
Follow-Up Studies
Humans
Hydrostatic Pressure
Infant
Infant, Newborn
Intussusception
Patient Discharge
Recurrence
Retrospective Studies
Treatment Outcome