Management and prognostic indicators of intussusception: spotlight on spontaneous reduction in a 15-year study

Abstract Background Intussusception is a significant paediatric emergency requiring timely diagnosis and management. This study aims to analyse the clinical features, treatment modalities, and outcomes of intussusception cases at a tertiary care centre in South Kerala, India over a 15-year period, with special focus on spontaneous reduction and its clinical predictors. Methods A retrospective analysis was conducted on 601 cases of intussusception from 2007 to 2022, reported to a tertiary care centre in South Kerala, India. Data collected included demographics, clinical features at presentation, and treatment modalities: spontaneous reduction, saline hydrostatic reduction (SHR), and surgical intervention. Statistical analyses were performed to identify factors associated with spontaneous reduction, successful SHR, and the need for surgery. Results The study population comprised 61.1% males and 38.9% females, with a mean age of 23.58 months. Typical cry (99.3%), poor feeding (88.4%), and vomiting (77.7%) were the most frequent clinical features. Spontaneous reduction occurred in 18.8% of cases. SHR was attempted in 80.0% of cases, with a success rate of 94.2%. Surgical intervention was required in 5.8% of cases. Older age (> 2 years), absence of vomiting, absence of red stools, absence of a palpable abdominal mass, and presence of enteritis were associated with spontaneous reduction. The absence of red stools and female gender were associated with successful SHR. The presence of vomiting, red stools, and a palpable abdominal mass were associated with the need for surgical intervention. Conclusion Recognizing predictors of spontaneous reduction—older age (> 2 years), absence of red stools/vomiting, absence of palpable abdominal mass and enteritis—can guide conservative management, reducing unnecessary procedures. Early recognition and timely intervention significantly increase the likelihood of non-operative management success. Incorporating these predictors into triage protocols may reduce surgical rates and improve outcomes.