Non-Sonographic Hydrostatic Reduction of Intussusception in Children in Underdeveloped Pakistan

Background: Intussusception is a significant cause of pediatric intestinal obstruction that requires rapid intervention. While ultrasound-guided hydrostatic reduction is the standard treatment in developed healthcare systems, its availability is limited in resource-limited settings. This study evaluated the efficacy and safety of non-sonographic-guided hydrostatic reduction for the treatment of pediatric intussusception in a resource-limited setting in Pakistan. Methods: A prospective descriptive case series study was conducted between January 2022 and January 2024 at Timergara Teaching Hospital involving 120 children aged 6 months to 3 years with ultrasound-confirmed acute ileocolic intussusception. A consecutive sampling technique was used to include all eligible patients during the study period. Success rates were analyzed for different age groups and symptom durations. Data analysis was conducted using IBM SPSS Statistics v20.0. Continuous variables were presented as mean ± SD or median (IQR), while categorical variables were shown as frequencies and percentages. Chi-square tests analyzed categorical data, and stratification by age, symptom onset, clinical signs, and vital signs minimized confounders. Statistical significance was set at p < 0.05. Results: The overall success rate of hydrostatic reduction was 90.0% (n=108). Male patients accounted for 68 (56.7%) cases. The highest success rates were observed in children aged 7-12 months (n= 45; 91.8%) and in cases treated within 6-12 hours of symptom onset (n= 67; 95.7%). Success rates decreased significantly with increasing duration of symptoms, dropping to 10 (76.9%) cases treated after 24 hours (p=0.035). The most common symptoms were abdominal pain (n=112; 93%), fever (103; 86%), and a palpable abdominal mass (95; 79%). Conclusion: Non-sonographic guided hydrostatic reduction is a highly effective treatment for uncomplicated pediatric intussusception in resource-limited settings, especially when performed within 12 hours of symptom onset. Early intervention is critical for optimal outcomes.