Point-of-Care Ultrasound-Guided Hydrostatic Reduction of Ileocolic Intussusception in the Pediatric Emergency Department.

Abstract

Our study objective was to describe our experience with POCUS-guided hydrostatic reductions of ileocolic intussusception performed by a PEM physician at the bedside in the pediatric emergency department (PED). We describe a case series of children aged 3 to 36 months with ileocolic intussusception in the PED who received a bedside POCUS-guided hydrostatic reduction between May 2022 and November 2025 in our secondary care hospital. Data collected included the time from presentation to successful POCUS-guided hydrostatic reduction, success rate, complications, and 24-hour recurrence. A total of 9 bedside POCUS-guided hydrostatic reductions were performed in the PED by a PEM provider. Successful reduction was achieved in 8 out of 9 (88.9%) cases. The median time from PED arrival to successful POCUS-guided reduction was 1.69 hours (interquartile range 1.04 to 2.45). No complications or 24-hour recurrences occurred. One unsuccessful case was later identified to have a lead point requiring definitive surgical repair. Our case series of POCUS-guided hydrostatic reduction performed by a trained PEM physician at the bedside in the PED appears to highlight a safe and expedient form of treatment for ileocolic intussusception. This approach eliminates radiation exposure and may shorten time to intervention in certain cases, particularly in settings without dedicated pediatric radiology services. Further larger studies are needed to validate our findings.