Clinical Determinants of Unsuccessful Ultrasound-Guided Hydrostatic Saline Reduction in Children with Intussusception Post-Rotavirus Vaccine Introduction: Insights from a Tertiary Care Centre in Thrissur, Kerala, India.

ABSTRACT:

Objectives

Intussusception (IS) is a condition in which proximal segment of the bowel invaginates into its distal segment. IS in young children can usually be managed using non-invasive methods, such as hydrostatic saline reduction (HSR), and surgery is generally reserved for cases in which non-invasive methods have failed. This study was conducted as part of a larger multicenter IS surveillance study. The objective of this analysis was to identify clinical and demographic factors associated with failed HSR in children hospitalized with IS.

Methods

In this observational study, children aged < 2 y hospitalized with IS confirmed according to the Brighton Collaboration criteria at a tertiary care center in Kerala were enrolled after obtaining parental informed consent. Children who underwent spontaneous reduction were excluded. Enrolled children were followed up until discharge.

Results

Of the 137 children who underwent HSR, 131 (95.6%) procedures were successful. HSR failed in six children (4.4%), and they required surgery; however, there were no deaths. The factors associated with failed HSR included low socioeconomic status [83% (5/6) vs. 32.1% (42/131); p = 0.042], a left-sided mass detected on ultrasonography [50% (3/6) vs. 6.9% (9/131); p = 0.004], and longer time from admission to the procedure (median: 5.5 vs. 3 h; p = 0.005).

Conclusions

This study demonstrates the importance of early HSR and exercising caution when a left-sided mass is detected on ultrasonography. With timely intervention, almost all cases can be successfully managed without surgery.

SUBMITTER: Namboodiripad A 

PROVIDER: S-EPMC12759000 | biostudies-literature | 2025 Dec

REPOSITORIES: biostudies-literature