# Intussusception — GCMD Library living collection

Everything in the library about intussusception — built automatically from dossiers that name it.

Updated: n/a · 8 episodes · 73 cited statements

## Episodes
### Acute Management
- [Repeat Enema for Intussusception: Update Course 2016](https://origin-library.globalcastmd.com/watch/repeat-enema-for-intussusception-update-course-2016-976) — video · 3:21 · [machine version](https://origin-library.globalcastmd.com/watch/repeat-enema-for-intussusception-update-course-2016-976.md)
- [Intussusception Guideline](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529) — video · [machine version](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529.md)

### Evidence & Research
- [Reduction of intussusception with saline enema superior to air enema](https://origin-library.globalcastmd.com/watch/reduction-of-intussusception-with-saline-enema-superior-to-air-enema-317) — video · [machine version](https://origin-library.globalcastmd.com/watch/reduction-of-intussusception-with-saline-enema-superior-to-air-enema-317.md)
- [Discharge after Reduction of Intussusception Is Safe and Effective](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150) — video · [machine version](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150.md)
- [Case-Based Journal Review- Intussusception in 2022](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092) — podcast · 20:19 · [machine version](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092.md)
- [Journal of Pediatric Surgery Article Review: The Disruption Score](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359) — video · 12:11 · [machine version](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359.md)

### Case-Based Learning
- [Intussusception - Soft Tissue Abscess - Pilonidal Cyst - Bleeding Meckel's...](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678) — video · 19:53 · [machine version](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678.md)

### In-Depth Reviews
- [Intussusception](https://origin-library.globalcastmd.com/watch/intussusception-2301) — video · [machine version](https://origin-library.globalcastmd.com/watch/intussusception-2301.md)

## Chapters
- [0:00](https://origin-library.globalcastmd.com/watch/reduction-of-intussusception-with-saline-enema-superior-to-air-enema-317?t=0) Introduction and presenter handoff (Ep 1)
- [0:16](https://origin-library.globalcastmd.com/watch/reduction-of-intussusception-with-saline-enema-superior-to-air-enema-317?t=16) Study design and primary outcomes (Ep 1)
- [1:18](https://origin-library.globalcastmd.com/watch/reduction-of-intussusception-with-saline-enema-superior-to-air-enema-317?t=78) Clinical context and implications for practice (Ep 1)
- [0:00](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=0) Intussusception: Post-Reduction Management and Lead Point Concerns (Ep 2)
- [5:43](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=343) Soft Tissue Abscess: Drainage Location, Packing, and Discharge Criteria (Ep 2)
- [9:49](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=589) Pilonidal Disease: Timing of Definitive Surgery and Operative Techniques (Ep 2)
- [15:10](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=910) Meckel Diverticulum Bleeding: Diagnostic Workup and Surgical Approach (Ep 2)
- [0:00](https://origin-library.globalcastmd.com/watch/repeat-enema-for-intussusception-update-course-2016-976?t=0) Clinical scenario and initial management options (Ep 3)
- [1:01](https://origin-library.globalcastmd.com/watch/repeat-enema-for-intussusception-update-course-2016-976?t=61) Evidence review for repeat enema success rates (Ep 3)
- [2:35](https://origin-library.globalcastmd.com/watch/repeat-enema-for-intussusception-update-course-2016-976?t=155) Timing considerations and operative outcomes (Ep 3)
- [0:00](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=0) Study overview and protocol description (Ep 4)
- [2:43](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=163) Discussion of outcomes and implications (Ep 4)
- [0:00](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529?t=0) Introduction and scope of the intussusception guideline (Ep 5)
- [1:00](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529?t=60) Indications for urgent surgery consult and initial triage (Ep 5)
- [3:00](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529?t=180) Air enema protocol and observation after successful reduction (Ep 5)
- [5:00](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529?t=300) Repeat enema criteria and operative intervention (Ep 5)
- [0:00](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=0) Initial workup and diagnostic imaging for intussusception (Ep 6)
- [4:08](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=248) Reduction techniques and number of attempts (Ep 6)
- [6:48](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=408) Criteria for successful reduction and repeat attempts (Ep 6)
- [11:30](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=690) Surgical approach: laparoscopic versus open (Ep 6)
- [15:43](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=943) Post-reduction observation and discharge protocols (Ep 6)
- [0:00](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=0) Case presentation and initial diagnostic approach (Ep 7)
- [2:12](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=132) Point-of-care ultrasound accuracy and institutional considerations (Ep 7)
- [4:50](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=290) Reduction methods: air versus saline enema (Ep 7)
- [7:05](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=425) Predictors of failed reduction (Ep 7)
- [9:33](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=573) Sedation and analgesia strategies (Ep 7)
- [12:32](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=752) Post-reduction disposition and outpatient management (Ep 7)
- [14:21](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=861) Recurrence rates and risk factors (Ep 7)
- [17:07](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=1027) Summary and clinical practice implications (Ep 7)
- [0:03](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=3) Introduction and Context for Bibliometric Tools (Ep 8)
- [2:11](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=131) Explaining the Disruption Score Formula and Interpretation (Ep 8)
- [7:01](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=421) Study Results and Top-Ranked Papers (Ep 8)
- [9:21](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=561) Limitations, Future Applications, and Conclusions (Ep 8)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- Cincinnati changed practice 6-8 months ago to discharge intussusception patients home from the ER after a 4-hour observation period if they tolerate feeds and are hemodynamically stable. — Todd Ponsky (clinical) [Ep 2 · 0:57](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=57)
- The repeat enema study after initial reduction does not actually reduce the intussusception again; it proves the first reduction was successful because the edema has now resolved. (clinical) [Ep 2 · 3:04](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=184)
- Ultrasound after intussusception reduction is difficult to interpret due to inflammation, so a contrast enema is preferred for confirmation. — Todd Ponsky (clinical) [Ep 2 · 3:19](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=199)
- One surgeon previously removed the appendix during operative intussusception reduction but now leaves it in due to concern about appendiceal stump dehiscence if reoperation is needed. — Todd Ponsky (opinion) [Ep 2 · 3:43](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=223)
- For intussusception in a 6-year-old, one approach is to attempt radiologic reduction, then work up for lead point electively and perform resection in a non-inflamed setting. — Todd Ponsky (clinical) [Ep 2 · 4:22](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=262)
- Many soft tissue abscesses are drained in the emergency department by ED physicians with sedation, not in the operating room. — Todd Ponsky (clinical) [Ep 2 · 6:50](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=410)
- Vessel loops are used as wicks for abscess drainage instead of traditional packing by some surgeons. (clinical) [Ep 2 · 7:41](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=461)
- Admission criteria for soft tissue abscess include cellulitis, fever, and leukocytosis in some combination; if the child appears sick, admission is warranted. — Todd Ponsky (clinical) [Ep 2 · 8:08](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=488)
- Antibiotics are prescribed for soft tissue abscess only if cellulitis is present; otherwise patients go home without antibiotics. (clinical) [Ep 2 · 8:31](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=511)
- In a retrospective review of abscess I&D cases discharged same-day from the OR, treatment failure (readmission or repeat I&D within 2 weeks) occurred in only 0.9% of patients. — Nick Bruns (epidemiological) [Ep 2 · 8:44](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=524)
- Among patients with leukocytosis (white count up to 35), only 2 out of 138 had treatment failure after same-day discharge, and only one febrile patient had treatment failure. — Nick Bruns (epidemiological) [Ep 2 · 9:11](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=551)
- For pilonidal disease, one surgeon operates after the second recurrence, though tries to delay as long as possible. — Todd Ponsky (opinion) [Ep 2 · 10:27](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=627)
- For recurrent pilonidal disease or large draining sinuses, formal excision with off-midline layered closure and drain placement is performed. (clinical) [Ep 2 · 11:37](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=697)
- Physical exam findings such as deep gluteal fold and excessive hair are high-risk factors that may influence timing and type of pilonidal surgery. — Todd Ponsky (clinical) [Ep 2 · 12:24](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=744)
- For severe recurrent pilonidal disease, open excision with wet-to-dry dressing changes or wound vac is used. — Todd Ponsky (clinical) [Ep 2 · 12:50](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=770)
- The key to preventing pilonidal recurrence is post-operative management: keeping the patient prone on bed rest until the wound heals, as it is primarily a wound healing problem from sitting on the surgical site. — Todd Ponsky (opinion) [Ep 2 · 13:43](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=823)
- Plastic surgeons perform flap procedures for recurrent pilonidal disease and keep patients prone post-operatively. — Todd Ponsky (clinical) [Ep 2 · 14:02](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=842)
- Some surgeons have sent patients for laser hair removal without complaints, though ensuring adequate treatment area and obtaining insurance reimbursement remain challenges. — Todd Ponsky (clinical) [Ep 2 · 14:42](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=882)
- After a negative Meckel scan in a child with hematochezia, one approach is colonoscopy with intent to proceed to laparoscopy if negative, ideally under the same anesthetic. (clinical) [Ep 2 · 15:34](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=934)
- Starting a PPI for suspected Meckel diverticulum bleeding will stop the bleeding temporarily; it should never be an emergency operation. (clinical) [Ep 2 · 16:09](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=969)
- For a bleeding Meckel diverticulum, if there is an ulcer at the base, segmental small bowel resection is performed rather than simple diverticulectomy. — Todd Ponsky (clinical) [Ep 2 · 17:00](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=1020)
- One position is that stapling off a bleeding Meckel removes the acid source, so the ulcer will heal without needing bowel resection, similar to vagotomy for peptic ulcer disease. (opinion) [Ep 2 · 17:39](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=1059)
- The ectopic gastric mucosa in Meckel diverticulum is almost always at the tip of the diverticulum. — Todd Ponsky (clinical) [Ep 2 · 18:09](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=1089)
- When performing Meckel diverticulectomy by pulling the diverticulum out through the umbilicus, marking the bowel edge with a marker while it is relaxed (not under tension) helps avoid narrowing the bowel lumen. — Todd Ponsky (clinical) [Ep 2 · 18:48](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=1128)
- High-volume centers where non-radiologists (surgeons or ED physicians) perform frequent ultrasounds can achieve good diagnostic results for intussusception. — Todd Ponsky (opinion) [Ep 7 · 2:52](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=172)
- It would be irresponsible for institutions to adopt POCUS for intussusception based solely on this study without adequate training and volume. — Todd Ponsky (opinion) [Ep 7 · 3:50](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=230)
- The hydrostatic versus air reduction study validates an alternative reduction method showing at least equivalent results. — Todd Ponsky (opinion) [Ep 7 · 6:04](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=364)
- COVID-era hospital bed and staff scarcity is forcing reconsideration of routine admission practices, and intussusception is an example where evidence supports not admitting by default. — Todd Ponsky (opinion) [Ep 7 · 13:46](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=826)
- Standard practice in many US institutions is to admit intussusception patients overnight and discharge the next morning, not keep them for 48 hours. — Todd Ponsky (clinical) [Ep 7 · 16:50](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=1010)
- There was not a higher rate of operative resection if repeat enema was delayed and the patient ultimately required surgery — David (clinical) [Ep 3 · 2:35](https://origin-library.globalcastmd.com/watch/repeat-enema-for-intussusception-update-course-2016-976?t=155)
- Radiologists may be reluctant to attempt repeat enema after pushing 120 centimeters pressure on initial attempt — Avi (opinion) [Ep 3 · 0:48](https://origin-library.globalcastmd.com/watch/repeat-enema-for-intussusception-update-course-2016-976?t=48)
- Success of repeat enema is radiology and system dependent — Avi (opinion) [Ep 3 · 0:48](https://origin-library.globalcastmd.com/watch/repeat-enema-for-intussusception-update-course-2016-976?t=48)
- The H-index (Hirsch index) represents the influence or impact of a particular author, with higher values indicating greater impact. — Mark Davenport (clinical) [Ep 8 · 2:34](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=154)
- Dr. George Holcomb has an H-index of 51, reflecting extensive publication over his surgical career. — Mark Davenport (epidemiological) [Ep 8 · 2:58](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=178)
- Dr. Shah, the senior author of the disruption score paper, has an H-index of 8, which is typical of a fairly average pediatric surgeon. — Mark Davenport (epidemiological) [Ep 8 · 3:07](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=187)
- If future papers cite only the index paper and not its references, that paper is considered more disruptive; if they cite both the index paper and its references, it is less disruptive and more developmental. — Mark Davenport (clinical) [Ep 8 · 3:43](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=223)
- The disruption score ranges from -1 to +1, with +1 being the most disruptive and -1 representing developmental papers. — Wynn Sullivan (clinical) [Ep 8 · 4:03](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=243)
- The disruption score is calculated as (A-B)/(A+B+C), where A is citations without the index paper's references, B is citations including both the index paper and its references, and C is citations of references only without the index paper. — Wynn Sullivan (clinical) [Ep 8 · 4:44](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=284)
- In an example calculation, a paper cited 100 times with 90 citations not including references (A=90), 10 citations including both (B=10), and 20 citations of references only (C=20) yields a disruption score of 0.66. — Wynn Sullivan (clinical) [Ep 8 · 5:03](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=303)
- Michael Gauderer's paper describing percutaneous endoscopic gastrostomies, with Jeff Ponsky as second author, ranked number 1 in the top 100 most disruptive papers. — Mark Davenport (epidemiological) [Ep 8 · 7:18](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=438)
- The number 2 ranked paper was a large series on intussusception. — Mark Davenport (epidemiological) [Ep 8 · 7:51](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=471)
- The number 3 ranked paper was a large series on fundoplications. — Mark Davenport (epidemiological) [Ep 8 · 7:54](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=474)
- A paper on internet use in families of children requiring cardiac surgery ranked number 6, which Dr. Davenport found surprising. — Mark Davenport (epidemiological) [Ep 8 · 8:05](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=485)
- A case report on fibrous fusion between liver and lung, cited only 17 times, ranked number 7 on the list. — Mark Davenport (epidemiological) [Ep 8 · 8:12](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=492)
- Different areas within pediatric surgery showed varying patterns, with some fields having more developmental research (like neuroblastoma) and others having more innovation and disruptive articles (like trauma). — Wynn Sullivan (epidemiological) [Ep 8 · 8:48](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=528)
- Dr. Davenport considers the article original but does not believe the disruption score stands up by comparison to conventional citation scores as the key method of assessing a paper's impact. — Mark Davenport (opinion) [Ep 8 · 10:20](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=620)
- Dr. Ponsky suggests that if people make the effort to use the disruption score metric over the next several years, it may become widely adopted. — Todd Ponsky (opinion) [Ep 8 · 10:56](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=656)
- Dr. Ponsky proposes that young authors and academicians could start including disruption scores on their CVs, which would generate interest and questions from reviewers. — Todd Ponsky (opinion) [Ep 8 · 11:08](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=668)
- Radiologists at some institutions refuse to perform enema without plain film to rule out free air — Todd Ponsky (clinical) [Ep 6 · 2:05](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=125)
- Reduction attempts fail in two ways: intussusceptum moves to mid-right colon but cannot progress further, or complete reduction occurs without reflux through ileocecal valve meeting radiographic criteria (clinical) [Ep 6 · 6:48](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=408)
- If reduction progresses all the way to ileocecal valve without reflux, patients' symptoms typically resolve and they can be safely observed or confirmed with ultrasound — Todd Ponsky (clinical) [Ep 6 · 7:57](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=477)
- In study of patients reduced to ileocecal valve without reflux, repeat contrast enemas the next day were all normal (clinical) [Ep 6 · 9:09](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=549)
- Patients with incomplete reduction continue to have recurrent colicky pain similar to pre-reduction symptoms, while those completely reduced are asymptomatic even without ileal reflux (clinical) [Ep 6 · 9:55](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=595)
- Time lapse between reduction attempts is typically 1-2 hours, though timing depends on when first attempt was performed (clinical) [Ep 6 · 10:18](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=618)
- Early laparoscopic intussusception cases that appeared to be easy reductions were often already reduced by radiology but not called as such due to lack of ileal reflux — Todd Ponsky (opinion) [Ep 6 · 11:00](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=660)
- As radiology success rates have increased, surgical cases have become more challenging because easy reductions are now handled non-operatively — Todd Ponsky (opinion) [Ep 6 · 13:18](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=798)
- Patients who travel 2-4 hours from outside facilities and had initial CT scan may receive another CT scan at outside facility if symptoms recur, influencing admission decisions (clinical) [Ep 6 · 16:08](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=968)
- Patients have more crampy pain in first few hours after air reduction compared to contrast reduction due to increased gas distension (clinical) [Ep 6 · 17:04](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=1024)
- Incidental small bowel intussusception seen on imaging can be observed, but postoperative small bowel intussusception warrants laparoscopy or operation — Todd Ponsky (clinical) [Ep 6 · 21:47](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=1307)
- The guideline is for evaluation and management of patients who present to the ER with a history suggestive of intussusception. — Meera Kotagal (guideline) [Ep 5 · 0:00](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529?t=0)
- Indications for urgent surgery consult include acute abdomen, abnormal vital signs, ill-appearing patient, or other concerns from ED providers. — Meera Kotagal (guideline) [Ep 5 · 1:00](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529?t=60)
- Once evaluated by a surgeon, a decision is made whether the patient needs emergent OR; if stable and not needing urgent intervention, the next step is ultrasound. — Meera Kotagal (guideline) [Ep 5 · 2:00](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529?t=120)
- If ultrasound is positive for intussusception, a surgical consult is called if not previously obtained. — Meera Kotagal (guideline) [Ep 5 · 3:00](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529?t=180)
- Patients with positive ultrasound undergo air enema, and surgeons must be aware of the patient prior to the enema. — Meera Kotagal (guideline) [Ep 5 · 3:30](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529?t=210)
- In-person surgical evaluation can occur before or after the air enema if the patient is clinically stable. — Meera Kotagal (guideline) [Ep 5 · 4:00](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529?t=240)
- If air enema successfully reduces the intussusception, patients are observed in the ED for four hours, then have a PO trial and can be discharged if clinically well. — Meera Kotagal (guideline) [Ep 5 · 4:30](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529?t=270)
- If the first air enema attempt fails to reduce the intussusception, the enema can be repeated every hour for up to three times with monitoring in between, as long as the intussusceptum continues to reduce, there is no free air, and the patient remains clinically stable. — Meera Kotagal (guideline) [Ep 5 · 5:00](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529?t=300)
- A fellow or attending surgeon should be notified if the patient is undergoing more than one air enema. — Meera Kotagal (guideline) [Ep 5 · 6:00](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529?t=360)
- If the intussusceptum cannot be completely reduced after three air enema attempts, the patient goes to the OR for manual reduction. — Meera Kotagal (guideline) [Ep 5 · 6:30](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529?t=390)
- This guideline may not apply to all patients. — Meera Kotagal (opinion) [Ep 5 · 7:00](https://origin-library.globalcastmd.com/watch/intussusception-guideline-1529?t=420)
- Historical practice evolved from barium enemas under fluoroscopy to pneumatic reduction under fluoroscopy — Todd Ponsky (clinical) [Ep 1 · 1:18](https://origin-library.globalcastmd.com/watch/reduction-of-intussusception-with-saline-enema-superior-to-air-enema-317?t=78)
- Saline enemas under ultrasound avoid fluoroscopy exposure — Alex Gibbons (clinical) [Ep 1 · 1:42](https://origin-library.globalcastmd.com/watch/reduction-of-intussusception-with-saline-enema-superior-to-air-enema-317?t=102)
- This represents a potential game-changing approach that merits consideration for trial in the United States — Todd Ponsky (opinion) [Ep 1 · 1:18](https://origin-library.globalcastmd.com/watch/reduction-of-intussusception-with-saline-enema-superior-to-air-enema-317?t=78)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- In a series of 48 intussusception patients discharged from the ED, only one recurred within 48 hours and that patient did not require operation, only repeat reduction. — Nick Bruns summarizing the discussion [Ep 2 · 2:01](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=121)
- When contrast fills the appendix but does not reflux into small bowel after intussusception reduction, this is attributed to ileocecal edema; the recommendation is to observe and repeat the study in a few hours. — Nick Bruns summarizing the discussion [Ep 2 · 2:44](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=164)
- Age over 5 years is the inflection point for pathologic lead point in intussusception, with 30-60% of cases in this age group having a lead point depending on the series. — Nick Bruns summarizing the discussion [Ep 2 · 5:28](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=328)
- A study at ABSA showed that packing abscesses did not make a difference in outcomes, yet surgeons continue to use packing or wicks. — Todd Ponsky summarizing the discussion [Ep 2 · 7:55](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=475)
- The Bascom technique involves excising pits with an 11 blade at skin level under local anesthesia, allowing healing by secondary intention; 70% of patients do not recur, though there is no control group. — The host summarizing the discussion [Ep 2 · 10:54](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=654)
- The Karydakis flap is superior to excision alone for pilonidal disease and comparable to the modified Limberg flap; the modified elliptical rotation flap has comparable short-term results. — Ian Glenn summarizing the discussion [Ep 2 · 13:04](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=784)
- One patient reported laser hair removal for pilonidal disease was the most painful thing he had experienced and discontinued treatment after half a session. — Todd Ponsky summarizing the discussion [Ep 2 · 14:26](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=866)
- Bill Gazetta taught at the fellows course that ulcers in Meckel bleeding are in the Meckel diverticulum itself, not in the adjacent small bowel. — Todd Ponsky summarizing the discussion [Ep 2 · 17:29](https://origin-library.globalcastmd.com/watch/intussusception-soft-tissue-abscess-pilonidal-cyst-bleeding-meckel-s-678?t=1049)
- Point-of-care ultrasound for intussusception diagnosis achieved 95% sensitivity and 99% specificity in a 2019 American Journal of Emergency Medicine study. — Rod Gerardo summarizing a resource [Ep 7 · 2:12](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=132)
- Ultrasound-guided hydrostatic reduction had 95.8% success rate versus 93.1% for fluoroscopy-guided air reduction in a 2021 World Journal of Emergency Surgery study from China. — Rod Gerardo summarizing a resource [Ep 7 · 5:08](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=308)
- The 2% difference in success rates between hydrostatic and air reduction is not clinically significant enough to justify changing established practice. — Ellen Encisco summarizing a resource [Ep 7 · 6:04](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=364)
- Obstructive bowel gas pattern on radiograph is associated with decreased air enema success and increased need for surgical bowel resection in a 2020 Pediatric Radiology study. — Rod Gerardo summarizing a resource [Ep 7 · 7:20](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=440)
- A 2018 Journal of Pediatric Surgery prediction model using clinical and sonographic data (free fluid, extension beyond splenic flexure, altered Doppler) identified 80% of failed saline enema reductions before the procedure. — Rod Gerardo summarizing a resource [Ep 7 · 8:29](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=509)
- Sedation for pneumatic reduction showed slightly better success rate but higher recurrence rate (5.1% vs 1.3%, non-significant) and more perforations (3 vs 0, non-significant) in a 2017 Pediatric Anesthesia study. — Ellen Encisco summarizing a resource [Ep 7 · 9:54](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=594)
- S-ketamine sedation versus morphine analgesia showed non-significant differences in success rate (90% vs 70%) and recurrence (10% vs 15%) with no perforations in either group. — Rod Gerardo summarizing a resource [Ep 7 · 10:59](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=659)
- If sedation shows no increased perforation risk compared to no sedation, then sedating children for comfort during reduction is justified. — Ellen Encisco summarizing a resource [Ep 7 · 11:47](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=707)
- A 2019 JPS systematic review and meta-analysis of 10 studies found no significant difference in ED returns, recurrence, need for operation, or mortality between inpatient and outpatient management after successful air enema reduction. — Rod Gerardo summarizing a resource [Ep 7 · 12:48](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=768)
- A 2020 Journal of Pediatric Surgery database study of 8,289 patients found 3.7% readmission and recurrence rate after intussusception reduction. — Rod Gerardo summarizing a resource [Ep 7 · 14:55](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=895)
- A 2020 Pediatric Emergency Care study of 200 cases found 13.5% overall recurrence rate with 7.3% recurring within 48 hours, with fever and female sex as risk factors for early recurrence. — Todd Ponsky summarizing a resource [Ep 7 · 15:31](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=931)
- Both recent studies show lower recurrence rates (3.7-13.5%) than the traditionally quoted 15-20% that surgeons have been telling families. — Ellen Encisco summarizing a resource [Ep 7 · 16:17](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=977)
- Increasing tolerance for recurrence risk benefits the vast majority of children by avoiding unnecessary admission and its associated complications. — Ellen Encisco summarizing a resource [Ep 7 · 16:59](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=1019)
- In resource-limited settings without 24-hour radiology, unnecessary laparotomies are sometimes performed for intussusception diagnosis in the middle of the night. — Ellen Encisco summarizing a resource [Ep 7 · 3:14](https://origin-library.globalcastmd.com/watch/case-based-journal-review-intussusception-in-2022-5092?t=194)
- Five studies examined repeat enema for intussusception, with four showing over 50% success rates — The host summarizing the discussion [Ep 3 · 1:01](https://origin-library.globalcastmd.com/watch/repeat-enema-for-intussusception-update-course-2016-976?t=61)
- The mean success rate for repeat enema across studies is estimated at 60-70% — The host summarizing the discussion [Ep 3 · 1:50](https://origin-library.globalcastmd.com/watch/repeat-enema-for-intussusception-update-course-2016-976?t=110)
- Repeat enema should be performed if the initial attempt made any progress and the patient is stable — The host summarizing the discussion [Ep 3 · 2:05](https://origin-library.globalcastmd.com/watch/repeat-enema-for-intussusception-update-course-2016-976?t=125)
- More than likely the intussusception will be reduced on the second attempt if progress was made initially — The host summarizing the discussion [Ep 3 · 2:25](https://origin-library.globalcastmd.com/watch/repeat-enema-for-intussusception-update-course-2016-976?t=145)
- Tony Sandler's Toronto Sick Kids study used a 2-4 hour interval between enemas — The host summarizing the discussion [Ep 3 · 2:05](https://origin-library.globalcastmd.com/watch/repeat-enema-for-intussusception-update-course-2016-976?t=125)
- More recent studies used 6-12 hour intervals between enemas, typically waiting until morning — The host summarizing the discussion [Ep 3 · 2:20](https://origin-library.globalcastmd.com/watch/repeat-enema-for-intussusception-update-course-2016-976?t=140)
- The mean time interval between first and second enema in David's study was approximately 6 hours — The host summarizing the discussion [Ep 3 · 3:00](https://origin-library.globalcastmd.com/watch/repeat-enema-for-intussusception-update-course-2016-976?t=180)
- The disruption score is a bibliometric tool used to characterize pediatric surgery publications. — Mark Davenport summarizing the discussion [Ep 8 · 1:59](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=119)
- The study stopped analyzing articles around 2014, introducing a lag time limitation inherent to all bibliometric scores. — Rod Gerardo summarizing the discussion [Ep 8 · 9:29](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=569)
- There is no current method to identify important papers immediately upon release; the disruption score measures whether a paper changes the game over time, not whether it goes viral. — Rod Gerardo summarizing the discussion [Ep 8 · 9:52](https://origin-library.globalcastmd.com/watch/journal-of-pediatric-surgery-article-review-the-disruption-score-13359?t=592)
- Chinese RCT comparing ultrasound-guided saline enema versus air contrast enema found 96% success rate for ultrasound-guided versus 83% for air contrast — Todd Ponsky summarizing a resource [Ep 6 · 4:08](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=248)
- Ultrasound-guided saline enema uses lower intraluminal pressure (88 mmHg) compared to air contrast enema (120 mmHg) — Todd Ponsky summarizing a resource [Ep 6 · 5:25](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=325)
- Outside the United States, ultrasound-guided saline enemas are commonly performed for intussusception reduction — Todd Ponsky summarizing a resource [Ep 6 · 4:08](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=248)
- Some surgeons perform on-table air enema during laparoscopy to help push the intussusception, avoiding the need to pull which has traditionally been discouraged — Todd Ponsky summarizing a resource [Ep 6 · 11:58](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=718)
- Study of 51-52 patients found no difference in recurrence rates between overnight admission (15%) and four-hour observation (16%) after hydrostatic reduction — Todd Ponsky summarizing a resource [Ep 6 · 19:44](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=1184)
- Study of 51-52 patients found no difference in time to recurrence or adverse outcomes between overnight admission and four-hour observation — Todd Ponsky summarizing a resource [Ep 6 · 19:44](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=1184)
- Systematic review meta-analysis of 10 papers found no statistical difference in recurrence rates (6-8%), return to ED, need for operative intervention, or mortality between short observation and overnight admission — Todd Ponsky summarizing a resource [Ep 6 · 19:44](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=1184)
- Four-hour observation protocol after successful reduction significantly reduces length of stay and cost compared to overnight admission — The host summarizing a resource [Ep 6 · 21:47](https://origin-library.globalcastmd.com/watch/intussusception-2301?t=1307)
- The study is entitled Emergency Department discharge following successful radiologic reduction of ileocolic intussusception in children, a protocol-based prospective observational study, from Children's Mercy Hospital in Kansas City with Joseph Sushka as first author and Shawn St. Peter as senior author — Alex Gibbins summarizing a resource [Ep 4 · 0:00](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=0)
- Previously, the hospital had a protocol wherein all patients who had reduction of intussusception were admitted for observation to rule out recurrence — Alex Gibbins summarizing a resource [Ep 4 · 0:40](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=40)
- The authors felt that due to the low rate of recurrence in this patient population, they could be safely managed as outpatients — Alex Gibbins summarizing a resource [Ep 4 · 1:00](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=60)
- The study compared outcomes from 115 patients after implementation of the protocol to 90 patients prior to its adoption — Alex Gibbins summarizing a resource [Ep 4 · 1:15](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=75)
- In the new protocol, any patient with a diagnosis of intussusception received a surgical consult — Alex Gibbins summarizing a resource [Ep 4 · 1:30](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=90)
- Patients with peritoneal signs were taken to the operating room immediately — Alex Gibbins summarizing a resource [Ep 4 · 1:40](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=100)
- Patients without peritoneal signs underwent air contrast enema for attempted reduction — Alex Gibbins summarizing a resource [Ep 4 · 1:48](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=108)
- If the intussusception was unable to be reduced after three attempts, patients were taken to the operating room — Alex Gibbins summarizing a resource [Ep 4 · 1:55](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=115)
- If the reduction was successful, patients were observed in the ED for four hours — Alex Gibbins summarizing a resource [Ep 4 · 2:05](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=125)
- If patients had no recurrent symptoms during the 4-hour ED stay, they were discharged home — Alex Gibbins summarizing a resource [Ep 4 · 2:13](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=133)
- If symptoms returned during observation, patients had repeat ultrasound and repeat enema if the intussusception had returned — Alex Gibbins summarizing a resource [Ep 4 · 2:21](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=141)
- All patients who required repeat reduction were admitted for observation — Alex Gibbins summarizing a resource [Ep 4 · 2:32](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=152)
- When comparing the two groups, the authors found no difference in the rate of successful enema reduction — Alex Gibbins summarizing a resource [Ep 4 · 2:38](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=158)
- There was no difference in the rate of operative intervention between the two groups — Alex Gibbins summarizing a resource [Ep 4 · 2:48](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=168)
- There was no difference in the rate of recurrence between the two groups — Alex Gibbins summarizing a resource [Ep 4 · 2:55](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=175)
- There was no difference in readmission within 30 days between the two groups — Alex Gibbins summarizing a resource [Ep 4 · 3:01](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=181)
- In the post-protocol group, there was a decrease in admission by 66% — Alex Gibbins summarizing a resource [Ep 4 · 3:08](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=188)
- The length of stay was reduced by 15 hours in the post-protocol group — Alex Gibbins summarizing a resource [Ep 4 · 3:16](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=196)
- In the post-protocol group, there was an increased rate of return to the emergency department within 30 days — Alex Gibbins summarizing a resource [Ep 4 · 3:23](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=203)
- There was a shorter time frame from discharge to return to the ED in the post-protocol group — Alex Gibbins summarizing a resource [Ep 4 · 3:35](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=215)
- The increased ED return rate did not result in an actual increased readmission rate — Alex Gibbins summarizing a resource [Ep 4 · 3:43](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=223)
- The authors concluded that after successful reduction of intussusception, children can be observed in the emergency department and then discharged home if they have no recurrence of symptoms — Alex Gibbins summarizing a resource [Ep 4 · 3:52](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=232)
- Once the new protocol was instituted, admission rate was reduced from 100% down to 33% — The host summarizing a resource [Ep 4 · 2:43](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=163)
- Total length of stay was reduced by 15 hours after protocol implementation — The host summarizing a resource [Ep 4 · 2:58](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=178)
- There were no morbidities or major complications from doing this new protocol — Alex Gibbins summarizing a resource [Ep 4 · 3:06](https://origin-library.globalcastmd.com/watch/discharge-after-reduction-of-intussusception-is-safe-and-effective-1150?t=186)
- The study randomized 124 patients to either air contrast enema or hydrostatic enema under ultrasound guidance — Alex Gibbons summarizing a resource [Ep 1 · 0:16](https://origin-library.globalcastmd.com/watch/reduction-of-intussusception-with-saline-enema-superior-to-air-enema-317?t=16)
- Baseline characteristics were the same between groups except for shorter procedure time in the hydrostatic group — Alex Gibbons summarizing a resource [Ep 1 · 0:16](https://origin-library.globalcastmd.com/watch/reduction-of-intussusception-with-saline-enema-superior-to-air-enema-317?t=16)
- The primary outcome was success of non-operative management confirmed with post-procedure ultrasound — Alex Gibbons summarizing a resource [Ep 1 · 0:16](https://origin-library.globalcastmd.com/watch/reduction-of-intussusception-with-saline-enema-superior-to-air-enema-317?t=16)
- In the hydrostatic group, 96.77% of patients had successful reduction compared to 83.87% in the air contrast enema group — Todd Ponsky summarizes what Dr. Alex Gibbons said [Ep 1 · 1:18](https://origin-library.globalcastmd.com/watch/reduction-of-intussusception-with-saline-enema-superior-to-air-enema-317?t=78)
- Under all measured parameters, ultrasound-guided saline enema was superior to traditional air enemas under fluoroscopy — Alex Gibbons summarizing a resource [Ep 1 · 1:42](https://origin-library.globalcastmd.com/watch/reduction-of-intussusception-with-saline-enema-superior-to-air-enema-317?t=102)

## Changelog
- Sep 24: 5 items added automatically
- Sep 16: 3 items added automatically

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