Management of intussusception in children: A systematic review

Lorraine I. Kelley-Quon; L. Grier Arthur; Regan F. Williams; Adam B. Goldin; Shawn D. St. Peter; Alana L. Beres; Yue Yung Hu; Elizabeth J. Renaud; Robert Ricca; Mark B. Slidell; Amy Taylor; Caitlin A. Smith; Doug Miniati; Juan E. Sola; Patricia Valusek; Loren Berman; Mehul V. Raval; Ankush Gosain; Matthew B. Dellinger; Stig Sømme; Cynthia D. Downard; Jarod P. McAteer; Akemi Kawaguchi

doi:10.1016/j.jpedsurg.2020.09.055

Management of intussusception in children: A systematic review

Lorraine I. Kelley-Quon^*, L. Grier Arthur, Regan F. Williams, Adam B. Goldin, Shawn D. St. Peter, Alana L. Beres, Yue Yung Hu, Elizabeth J. Renaud, Robert Ricca, Mark B. Slidell, Amy Taylor, Caitlin A. Smith, Doug Miniati, Juan E. Sola, Patricia Valusek, Loren Berman, Mehul V. Raval, Ankush Gosain, Matthew B. Dellinger, Stig SømmeCynthia D. Downard, Jarod P. McAteer, Akemi Kawaguchi

^*Corresponding author for this work

Surgery

Research output: Contribution to journal › Review article › peer-review

27 Scopus citations

Abstract

Objective: The goal of this systematic review by the American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee was to develop recommendations for the management of ileocolic intussusception in children. Methods: The ClinicalTrials.gov, Embase, PubMed, and Scopus databases were queried for literature from January 1988 through December 2018. Search terms were designed to address the following topics in intussusception: prophylactic antibiotic use, repeated enema reductions, outpatient management, and use of minimally invasive techniques for children with intussusception. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. Consensus recommendations were derived based on the best available evidence. Results: A total of 83 articles were analyzed and included for review. Prophylactic antibiotic use does not decrease complications after radiologic reduction. Repeated enema reductions may be attempted when clinically appropriate. Patients can be safely observed in the emergency department following enema reduction of ileocolic intussusception, avoiding hospital admission. Laparoscopic reduction is often successful. Conclusions: Regarding intussusception in hemodynamically stable children without critical illness, pre-reduction antibiotics are unnecessary, non-operative outpatient management should be maximized, and minimally invasive techniques may be used to avoid laparotomy.

Original language	English (US)
Pages (from-to)	587-596
Number of pages	10
Journal	Journal of pediatric surgery
Volume	56
Issue number	3
DOIs	https://doi.org/10.1016/j.jpedsurg.2020.09.055
State	Published - Mar 2021

Keywords

enema
intussusception
outpatient
surgery

ASJC Scopus subject areas

Surgery
Pediatrics, Perinatology, and Child Health

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10.1016/j.jpedsurg.2020.09.055

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Kelley-Quon, L. I., Arthur, L. G., Williams, R. F., Goldin, A. B., St. Peter, S. D., Beres, A. L., Hu, Y. Y., Renaud, E. J., Ricca, R., Slidell, M. B., Taylor, A., Smith, C. A., Miniati, D., Sola, J. E., Valusek, P., Berman, L., Raval, M. V., Gosain, A., Dellinger, M. B., ... Kawaguchi, A. (2021). Management of intussusception in children: A systematic review. Journal of pediatric surgery, 56(3), 587-596. https://doi.org/10.1016/j.jpedsurg.2020.09.055

@article{1789ed6140484ecf9030443c8b4b8b9d,

title = "Management of intussusception in children: A systematic review",

abstract = "Objective: The goal of this systematic review by the American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee was to develop recommendations for the management of ileocolic intussusception in children. Methods: The ClinicalTrials.gov, Embase, PubMed, and Scopus databases were queried for literature from January 1988 through December 2018. Search terms were designed to address the following topics in intussusception: prophylactic antibiotic use, repeated enema reductions, outpatient management, and use of minimally invasive techniques for children with intussusception. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. Consensus recommendations were derived based on the best available evidence. Results: A total of 83 articles were analyzed and included for review. Prophylactic antibiotic use does not decrease complications after radiologic reduction. Repeated enema reductions may be attempted when clinically appropriate. Patients can be safely observed in the emergency department following enema reduction of ileocolic intussusception, avoiding hospital admission. Laparoscopic reduction is often successful. Conclusions: Regarding intussusception in hemodynamically stable children without critical illness, pre-reduction antibiotics are unnecessary, non-operative outpatient management should be maximized, and minimally invasive techniques may be used to avoid laparotomy.",

keywords = "enema, intussusception, outpatient, surgery",

author = "Kelley-Quon, {Lorraine I.} and Arthur, {L. Grier} and Williams, {Regan F.} and Goldin, {Adam B.} and {St. Peter}, {Shawn D.} and Beres, {Alana L.} and Hu, {Yue Yung} and Renaud, {Elizabeth J.} and Robert Ricca and Slidell, {Mark B.} and Amy Taylor and Smith, {Caitlin A.} and Doug Miniati and Sola, {Juan E.} and Patricia Valusek and Loren Berman and Raval, {Mehul V.} and Ankush Gosain and Dellinger, {Matthew B.} and Stig S{\o}mme and Downard, {Cynthia D.} and McAteer, {Jarod P.} and Akemi Kawaguchi",

note = "Funding Information: Author LIK is supported by grant KL2TR001854 from the National Center for Advancing Translational Science (NCATS) of the U.S. National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: {\textcopyright} 2020 Elsevier Inc.",

year = "2021",

month = mar,

doi = "10.1016/j.jpedsurg.2020.09.055",

language = "English (US)",

volume = "56",

pages = "587--596",

journal = "Journal of Pediatric Surgery",

issn = "0022-3468",

publisher = "W.B. Saunders Ltd",

number = "3",

}

Kelley-Quon, LI, Arthur, LG, Williams, RF, Goldin, AB, St. Peter, SD, Beres, AL, Hu, YY, Renaud, EJ, Ricca, R, Slidell, MB, Taylor, A, Smith, CA, Miniati, D, Sola, JE, Valusek, P, Berman, L, Raval, MV, Gosain, A, Dellinger, MB, Sømme, S, Downard, CD, McAteer, JP & Kawaguchi, A 2021, 'Management of intussusception in children: A systematic review', Journal of pediatric surgery, vol. 56, no. 3, pp. 587-596. https://doi.org/10.1016/j.jpedsurg.2020.09.055

TY - JOUR

T1 - Management of intussusception in children

T2 - A systematic review

AU - Kelley-Quon, Lorraine I.

AU - Arthur, L. Grier

AU - Williams, Regan F.

AU - Goldin, Adam B.

AU - St. Peter, Shawn D.

AU - Beres, Alana L.

AU - Hu, Yue Yung

AU - Renaud, Elizabeth J.

AU - Ricca, Robert

AU - Slidell, Mark B.

AU - Taylor, Amy

AU - Smith, Caitlin A.

AU - Miniati, Doug

AU - Sola, Juan E.

AU - Valusek, Patricia

AU - Berman, Loren

AU - Raval, Mehul V.

AU - Gosain, Ankush

AU - Dellinger, Matthew B.

AU - Sømme, Stig

AU - Downard, Cynthia D.

AU - McAteer, Jarod P.

AU - Kawaguchi, Akemi

N1 - Funding Information: Author LIK is supported by grant KL2TR001854 from the National Center for Advancing Translational Science (NCATS) of the U.S. National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: © 2020 Elsevier Inc.

PY - 2021/3

Y1 - 2021/3

N2 - Objective: The goal of this systematic review by the American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee was to develop recommendations for the management of ileocolic intussusception in children. Methods: The ClinicalTrials.gov, Embase, PubMed, and Scopus databases were queried for literature from January 1988 through December 2018. Search terms were designed to address the following topics in intussusception: prophylactic antibiotic use, repeated enema reductions, outpatient management, and use of minimally invasive techniques for children with intussusception. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. Consensus recommendations were derived based on the best available evidence. Results: A total of 83 articles were analyzed and included for review. Prophylactic antibiotic use does not decrease complications after radiologic reduction. Repeated enema reductions may be attempted when clinically appropriate. Patients can be safely observed in the emergency department following enema reduction of ileocolic intussusception, avoiding hospital admission. Laparoscopic reduction is often successful. Conclusions: Regarding intussusception in hemodynamically stable children without critical illness, pre-reduction antibiotics are unnecessary, non-operative outpatient management should be maximized, and minimally invasive techniques may be used to avoid laparotomy.

AB - Objective: The goal of this systematic review by the American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee was to develop recommendations for the management of ileocolic intussusception in children. Methods: The ClinicalTrials.gov, Embase, PubMed, and Scopus databases were queried for literature from January 1988 through December 2018. Search terms were designed to address the following topics in intussusception: prophylactic antibiotic use, repeated enema reductions, outpatient management, and use of minimally invasive techniques for children with intussusception. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed. Consensus recommendations were derived based on the best available evidence. Results: A total of 83 articles were analyzed and included for review. Prophylactic antibiotic use does not decrease complications after radiologic reduction. Repeated enema reductions may be attempted when clinically appropriate. Patients can be safely observed in the emergency department following enema reduction of ileocolic intussusception, avoiding hospital admission. Laparoscopic reduction is often successful. Conclusions: Regarding intussusception in hemodynamically stable children without critical illness, pre-reduction antibiotics are unnecessary, non-operative outpatient management should be maximized, and minimally invasive techniques may be used to avoid laparotomy.

KW - enema

KW - intussusception

KW - outpatient

KW - surgery

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U2 - 10.1016/j.jpedsurg.2020.09.055

DO - 10.1016/j.jpedsurg.2020.09.055

M3 - Review article

C2 - 33158508

AN - SCOPUS:85095574384

SN - 0022-3468

VL - 56

SP - 587

EP - 596

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

IS - 3

ER -

Management of intussusception in children: A systematic review

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