Vol. 2, Issue 1, Part A (2018)

Background: Intussusception is the most common cause of intestinal obstruction in infants and young children. Although hydrostatic reduction under ultrasonographic guidance is the preferred first-line treatment, a subset of patients require surgical intervention following failed non-operative management. Timely surgery in such cases is critical to reduce morbidity. This study aimed to analyze the clinical outcomes of early surgical intervention after failed hydrostatic reduction in pediatric intussusception.

Materials and Methods: This prospective observational study was conducted in the Department of Surgery, I-care Institute of Medical Sciences and Research, Haldia, from January 2017 to December 2017. Children aged 1 month to 5 years with sonographically confirmed intussusception who underwent attempted hydrostatic reduction followed by surgery upon failure were included. Hydrostatic reduction failure was defined by incomplete resolution after three attempts, clinical deterioration, or persistence of ultrasonographic findings. Operative findings, requirement for bowel resection, presence of pathological lead points, postoperative complications, and recovery outcomes were recorded and analyzed.

Results: A total of 35 children were enrolled. The mean age was 16.8±7.4 months, with a male predominance (62.9%). Ileocolic intussusception was the most common type (88.6%). Manual reduction during surgery was successful in 77.1% of cases, while bowel resection and anastomosis were required in 22.9%. Pathological lead points were identified in 14.3% of patients. Postoperative complications occurred in 17.1%, including wound infection and prolonged ileus. No mortality was recorded. The mean duration of hospital stay was 6.5±2.3 days, and the average time to initiation of oral feeding was 2.8±0.9 days.

Conclusion: Early surgical intervention after failed hydrostatic reduction in pediatric intussusception results in favorable outcomes with minimal morbidity and no mortality. Prompt referral and timely operative management play a crucial role in reducing the need for extensive bowel resection and improving recovery.