Abstract

Objective: This study aimed to investigate the disease profile in pediatric patients with intussusception and determine surgical intervention predictors.
Methods: This retrospective study analyzed 375 pediatric patients with intussusception over 10 years (January 2012 to December 2022). Patients with peritoneal findings on clinical examination, no attempts at pneumatic reduction, and those who declined treatment were excluded. The descriptive analysis identified patient characteristics and outcomes, whereas multivariable logistic regression determined factors contributing to surgical intervention.
Results: Of 375 cases, 312 cases (83%) achieved successful reduction, 2 (0.005%) experienced complications with perforation during pneumatic reduction, and 12 (3%) had recurrence. Surgical intervention was required in 63 cases (17%), with a pathological lead point identified in five cases (8%). Key factors associated with pneumatic reduction failure included age >3 years (p-value = 0.04), blood in the stool (p-value = 0.001), and the presence of an abdominal lump (p-value = 0.045). The number of attempts at pneumatic reduction was a strong predictive factor for surgical intervention, with an odds ratio of 27.39 (95% CI 10.66-70.42, p-value < 0.001) for two attempts and 49.81 (95% CI 20.03-123.85, p-value < 0.001) for three or more attempts, compared to patients with one attempt.
Conclusion: The results align with internationally published literature regarding success rates and the low risk of surgical intervention associated with pneumatic reduction. Repetitive pneumatic reduction should be approached with caution, and early surgical intervention should be considered in the presence of predictive factors.

Key words: Pediatric intussusception, pneumatic reduction, failure, outcomes, perforation