Vigilant Monitoring: Is there a Subset of Stable Patients with Intussusception in Children That Requires No Intervention? A Retrospective Observational Study

The minimal interventions are widely used and practiced for over five decades and encompass reduction techniques such as USGor fluoroscopy-guided saline enema/USG-guided pneumatic reduction. [4][5]5][6] However, if there is a possibility of a subset of patients who undergo spontaneous reduction, identifying them is of paramount importance, as any intervention, even minimal, has its complications.Therefore, defining or finding such a subset could help avoid unnecessary interventions.Although a spontaneous reduction rate ranging between 0.3 and 14% has been described in various previous studies, 7 they fail to mention the criteria that can help us define such a subset.Our study, thus, attempts to explain the subset with the help of a few criteria, which might help us select patients who can be kept under vigilant monitoring and therefore avoid interventions of any form. What i s KnoWn?• Ultrasonography (USG) is the gold standard for the diagnosis of intussusception.• In idiopathic intussusception, once confirmed, we go ahead with minimally invasive pneumatic reduction/hydrostatic reduction.• In failed reductions, exploration is needed.• No role of conservative management as of now. What i s neW?• To identify a subset of patients with idiopathic intussusception in whom spontaneous reduction without intervention is possible.• To try to define criteria for such a subset. introductionTelescoping of a segment of the intestine into its distal segment is described as intussusception. 1 Based on the segments involved, intussusceptions are broadly grouped into: jejunojejunal, ileoileal, ileocolic, colo-colic types, and a complex ileo-ileo-colic variant. 2 Among these groups, the ileo-colic type is encountered more often, accounting for up to 90%. 3 Around 80-90% of the cases are usually idiopathic with no specific attributable cause. [2][3]3][4] There is a significant proportion of intussusceptions, especially the small bowel intussusceptions, which undergo spontaneous resolution.However, if the size of the target sign is large, if there is a lead point, and if there are signs of ischemic changes on USG, then surgical exploration is needed. 5The management approach consists of both surgical interventions and minimally invasive interventions.