Sonographic guidance of air enema for intussusception reduction in children.

BACKGROUND: Fluoroscopically guided air reduction of intussusception is a well-accepted technique. There are only two previous reports in which US has been used to monitor pneumatic reduction.

OBJECTIVE: To assess the ability of US to monitor the success of air reduction of intussusception.

MATERIALS AND METHODS: Sonographically guided air-enema reduction of intussusception in 199 children. In phase I (11 children), the success or failure of reduction was confirmed by fluoroscopy. In phase II (188 children), complete reduction was confirmed by clinical improvement of the child and repeat sonography 1 h later showing no persistent intussusception.

RESULTS: In phase I, fluoroscopy confirmed the accuracy of US in all 11 children. In phase II, the success rate of initial reduction was 95%. Following successful reduction, US repeated 1 h later showed no recurrence of intussusception in 92%. In ten (5%) of 188, initial reduction was unsuccessful; fluoroscopically guided air reduction successfully reduced only three of these ten failures.

CONCLUSIONS: Air enema guided by US is a practical and reliable technique for the reduction of intussusception.