From
StayCurrentMD
Repeat Enema for Intussusception: Update Course 2016
Part of
Intussusception 8 items
Chapter 1 of 3 · Case-Based Learning
Case presentation
Clinical scenario and initial management options
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Radiologists may be reluctant to attempt repeat enema after pushing 120 centimeters pressure on initial attempt
Success of repeat enema is radiology and system dependent
There was not a higher rate of operative resection if repeat enema was delayed and the patient ultimately required surgery
Five studies examined repeat enema for intussusception, with four showing over 50% success rates
The mean success rate for repeat enema across studies is estimated at 60-70%
Repeat enema should be performed if the initial attempt made any progress and the patient is stable
Tony Sandler's Toronto Sick Kids study used a 2-4 hour interval between enemas
More recent studies used 6-12 hour intervals between enemas, typically waiting until morning
More than likely the intussusception will be reduced on the second attempt if progress was made initially
The mean time interval between first and second enema in David's study was approximately 6 hours