What Is the Treatment of Intussusception? First-Line Non-Operative Management
Clinical Scenario
Intussusception occurs when one segment of bowel telescopes into an adjacent segment, leading to obstruction that requires prompt management. The first-line strategy — where appropriate facilities and surgical backup are available — is non-operative reduction.
Treatment Approach
Management centres on non-operative reduction using an enema technique, carried out in consultation with a surgical team where paediatric surgical support is available. Appropriate peri-procedural support — including analgesia and, where indicated, sedation by an experienced clinician — is integral to the protocol.
The complete procedure details, technique selection, sedation guidance, and criteria for considering repeated attempts are set out in the structured regimen below.
References
- The enema may be used diagnostically and therapeutically in consultation with a surgical team.
- Appropriate peri-procedural analgesia is necessary, is usually intranasal fentanyl or IV morphine, see Acute pain management.
- Procedural sedation by an experienced clinician should be strongly considered, as this may improve the success rate of non-operative reduction, both hydrostatic and pneumatic enema.
- Repeated enemas may be considered and may increase success rates by 10% with few complications.
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