Frequency of Adverse Events and Appropriate Observational Duration after Successful Air Reduction of Childhood Intussusception

Park, Jong Dae; Kwak, Young Ho; Kim, Do Kyun; Lee, Jin Hee; Kim, Hahn Bom; Jung, Jae Yun

Abstract

PURPOSE
The aim of the study was to investigate the frequency of adverse events and the appropriate observational duration after successful air reduction of childhood intussusception.
METHODS
This was a retrospective, observational study of children, aged 0 to 14 years, who underwent successful air reduction after diagnosis of intussusception in two tertiary referral hospitals. The demographic data, onset time and type of intussusception, observational duration and frequency of adverse events after air reduction were collected. We categorized the adverse events as grade 1 to 5. Grade 1 is severe abdominal pain which requires analgesia; grade 2 is nausea and vomiting which require intravenous (IV) hydration; grade 3 is symptoms and signs requiring re-evaluation of ultrasonography (US), confirmed as no recurrence; grade 4 is symptoms and signs requiring re-evaluation of US, confirmed as recurrence; and grade 5 is failed second air reduction and consequent operation.
RESULTS
A total of 547 patients (369 boys and 178 girls) were enrolled. Mean age of the subjects was 24.1 months (SD: +/-19.3, range 1-144). The mean time duration from symptom onset to emergency department (ED) visit was 18.4 hours (SD: +/-18.5), and the average observational duration after the successful air reduction was 32.8 hours (SD: +/-29.1, range: 1-216). The number of children who suffered from the grade 1 to 5 of adverse events were 13 (2.4%), 2 (0.4%), 38 (6.9%), 33 (6%), and 2 (0.4%), respectively. A total of 17 (3.1%) children recurred after 24 hours of air reduction, 7 (1.3%) in the hospital and 10 (1.8%) after discharge. Among these patients, only one (0.2%) child under in-hospital observation underwent an operation.
CONCLUSION
A 24-hour long observation at ED after the successful air reduction allows the safe and feasible management of childhood intussusception.