EN
TÜRKÇE
Oral Presentation - 136
Standardization of a Pneumatic reduction protocol (PRP) for intussusception : Results of thirteen years of experience in a northern hospital in Mexico.
Jorge Cantu, Joel Cazares, Jorge colin, Diego Gutierrez
Hospital Regional Materno Infantil, Monterrey, Mexico
Abstract
Introduction:
Intussusception is a common cause of intestinal obstruction in infants. Although pneumatic reduction under fluoroscopic guidance is effective and minimally invasive, its implementation remains limited in resource-constrained settings.
Methods:
We performed a retrospective, descriptive study of all pediatric patients diagnosed with intussusception at our institution between January 2012 and May 2025. Patients were managed either with pneumatic reduction protocol (PRP) or primary surgery. PRP was reserved for hemodynamically stable patients without signs of peritonitis and with radiologic confirmation. We analyzed demographic and clinical variables, treatment outcomes, and performed exploratory statistical comparisons between symptom duration, age, number of PRP attempts, and clinical success or recurrence.
Results:
Of 1,087 patients, 798 (73.4%) underwent PRP. Overall success was 92%, with 78.2% resolving on the first attempt, 11.0% on the second, and 2.8% on the third. PRP failure occurred in 64 cases (8%), all requiring surgery; 10.9% underwent bowel resection, 7.8% diversion, and 46.9% appendectomy. Patients under 1 year-old had significantly higher success rates (p = 0.007), and those with symptom duration <24 hours were more likely to respond to PRP (p < 0.001). Early recurrence occurred in 2% of successful cases, all resolved with repeat PRP. Recurrence was more frequent in patients requiring multiple attempts (p = 0.001). No procedural complications such as perforation or bleeding were observed. Mean hospital stay among successful PRP cases was 1.4 days. We reduced hospitalization time and surgery cost for our institution.
Conclusion:
Our findings highlight PRP as a reliable, safe, and cost-effective first-line treatment for pediatric intussusception. Its implementation in resource-limited settings is feasible when supported by standardized protocols and appropriately trained personnel.