Factors influencing spontaneous reduction versus interventional management in pediatric intussusception: a prospective comparative study

Background and aims: Pediatric intussusception is a common abdominal emergency characterized by the telescoping of one segment of the intestine into another. Prompt diagnosis and management are crucial; however, in resource-limited settings, access to advanced diagnostic tools and interventional facilities may be inadequate. This study aimed to identify factors influencing spontaneous reduction versus interventional management, determine predictors of spontaneous reduction, and evaluate outcomes in a resource-constrained environment. Methods: This prospective observational study was conducted over 1 year at a tertiary care hospital. Ninety children under 6years of age diagnosed with intussusception via ultrasonography were enrolled. Participants were categorized into two groups: those who experienced spontaneous reduction and those who required intervention (hydrostatic reduction or surgery). Clinical, laboratory, and radiological variables were analyzed to identify predictors of spontaneous reduction using t-tests, chi-square tests, and logistic regression. Results: Of the 90 children, 44.4% achieved spontaneous reduction, while 55.6% required intervention. Inconsolable crying was identified as the most significant predictor for requiring intervention ( P = 0.035). Other factors such as age, weight, and the ultrasonographic size or location of the intussusception did not significantly predict treatment outcomes. Although hemoglobin levels initially appeared significant, they lost statistical significance in the multivariate analysis. Conclusion: Multiple factors may influence the spontaneous reduction of pediatric intussusception. Early diagnosis and careful observation can help avoid unnecessary interventions, optimize the use of limited resources, and improve clinical outcomes.