Purpose or Case Report: The influence of timing on reduction success in pediatric intussusception, specifically whether earlier intervention, classified as emergent (<2 hours) or urgent (2–8 hours), improves outcomes, remains debated. This project aims to inform institutional practices at a tertiary medical center, optimize resource allocation, and enhance patient outcomes through timely intervention and improved staffing protocols.
Methods & Materials: A retrospective review was conducted of all pediatric patients diagnosed and/or treated for intussusception at a single institution between 2016 and 2024. Demographic, clinical, and procedural data were collected, including intussusception type, treatment modality, imaging findings, timing from diagnosis to reduction, and outcomes. Patients were grouped by first-attempt reduction success and compared for presentation, timing, and clinical factors. Associations between categorical variables were evaluated using chi-square or Fisher’s exact tests, and relationships involving continuous variables were assessed using one-way ANOVA or linear regression. Positive-valued continuous variables were log-transformed to improve residual normality. All analyses were performed using R version 4.2.0.
Results: A total of 148 pediatric intussusception cases were identified; 121 (81.75%) were successfully reduced on the first air enema attempt. Of the 28 unsuccessful first attempts, 8 underwent a second fluoroscopic procedure (50% success), and 20 proceeded directly to surgery. The mean time from diagnosis to first reduction attempt was 1.37 hours. There was no significant difference in timing between successful and unsuccessful first-attempt reductions (p = 0.7104). Significant predictors of unsuccessful reduction included older age (p = 0.0306), elevated white blood cell count (p = 0.0102), and the presence of trapped fluid between intussuscepted loops on ultrasound (p = 0.0091).
Conclusions: Although reductions are traditionally performed within two hours of diagnosis to prevent adverse outcomes, our findings and recent literature suggest that brief delays for adequate staffing do not worsen success rates. Urgent (2–8 hours) versus emergent (<2 hours) reductions showed no significant difference in outcomes. These results indicate that modest procedural delays may facilitate more efficient resource utilization without compromising patient safety or clinical success.