Ultrasound-guided reduction of intussusception in infants in a developing world: saline hydrostatic or pneumatic technique?

Purpose: Non-operative reduction has emerged as first line in the management of uncomplicated intussusception. The aim of this study was to compare the outcome of saline hydrostatic reduction and pneumatic reduction of intussusception in infants. Methods This is a prospective study of infants with uncomplicated intussusception confirmed by ultrasound over a period of twenty-one months from December, 2018 to August, 2020. Fifty-two (69.3%) out of seventy-five infants underwent enema reduction under ultrasound guidance. The success rates, time to reduction and complication rates were assessed. Results The success rates, between the saline hydrostatic reduction group and pneumatic reduction group, were comparable [17(65.4%) versus 19(73.1%); relative risk (RR) 0.8; 95% confidence interval (CI) 0.6–1.2; p  = 0.54]. The mean time to reduction was higher in the saline hydrostatic reduction group (15.4 ± 5.1 minutes versus 10.8 ± 4.1 minutes; p = 0.003). The two groups had similar complication rates; for perforation [1(3.8%) versus 0(0.0%); RR 0.9 (CI 0.9-1.0); p = 0.31] and recurrence [2(7.7%) versus 1(3.8%); RR 0.9 (CI 0.8-1.0); p  = 0.55]. Conclusion Saline hydrostatic reduction and pneumatic reduction of uncomplicated intussusception under ultrasound guidance in infants might have comparable outcomes. However, pneumatic reduction may be faster.