Introduction:

intussusception is the most frequent cause of bowel obstruction in children under three years. Usually, after reduction, patients remain admitted for 24-48 hours. Ambulatory management has recently been proposed, based on clinical experience of follow-up of the patient's evolution in the Emergency Department of the hospital during the following 12 hours. Our objective is to evaluate the implementation of this new therapeutic attitude.

Material and methods:

retrospective review of all the intussusceptions treated at our center during the last 12 years.

Results:

458 patients were included, 60.3% ot them were male. Mean age was 24.1 months (SD 24.6), with the ileo-colic location being the most frequent (77.7%). 2.4% had secondary causes. A pneumoenema was performed in 370 children, requiring surgery 10.7%. There were 78 relapses in 56 patients (12.2%), 15 of them during admission. The mean time to reintroduce feeding and the mean hospital stay was 28.6 and 64.4 hours respectively, with no significant difference between those who relapsed and those who did not (60.8 vs 69 hours, t = -0.4, p = 0.689).

There was no relationship between a longer clinical evolution and pneumoenema succeed rate (t = 0.478, p = 0.634). Although there were differences in the need for surgical intervention (χ² = 5.604, p = 0.018), there were no complications. Early reintroduction of feeding was not related to any recurrences or differences between groups (30.2% in the relapsed group and 23.1% in the non-recurrent group, p = 0.608).

Conclusions:

hospital admission beyond 12 hours does not decrease the rate of complications. Therefore, we consider that outpatient observation for 12 hours after reduction is a safe and economical measure.

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