From
StayCurrentMD
Repeat Enema for Intussusception: Update Course 2016
Part of
Intussusception 4 items
Chapter 1 of 3 · Case-Based Learning
Case setup
Case presentation and initial management options
Cued at 0:48 · press play
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
There is data to suggest repeat enema should be attempted for partially reduced intussusception, but practice is radiology and system dependent
Some radiologists will not attempt repeat enema after pushing 120 centimeters pressure
There was not a higher rate of operative resection if repeat enema was attempted and the patient ultimately required surgery
Five studies examined repeat enemas for intussusception
Four studies showed over 50% success rate with repeat enema
The estimated mean success rate for repeat enema is around 60 to 70%
If the patient is stable and any progress was made during the first enema, repeat enema should be attempted
Tony Sandler's study from Toronto Sick Kids used a 2 to 4 hour interval between enemas
More recent studies used 6 to 12 hour intervals between enemas, typically waiting until the next morning
David's study found a mean interval of about 6 hours between first and second enema