Transabdominal manually assisted reduction of pediatric intussusception: reappraisal of this historical technique.

Abstract

To determine whether manual manipulation of the abdomen during intussusception reduction improves the success rate or affects morbidity. A retrospective study was performed in 38 cases of intussusception in 35 children over a 33-month period at a pediatric hospital. In all cases, pneumostatic pressure was used as the initial method of treatment. A comparative review of the intussusception literature was also performed. Reduction was achieved with pneumostatic pressure alone in 22 cases (an initial success rate of 58%). Transabdominal manual manipulation was used in 10 cases after initial pneumostatic reduction failed; seven of these 10 cases were treated successfully. These seven additional successes, attributed to manual assistance, significantly improved the success rate from 58% to 76% (P < .016). No perforation or other complication occurred. These results and findings of the literature review indicate that transabdominal manual assistance during reduction is a potentially useful technique that has been shunned without scientific basis for longer than 40 years.