WOFAPS 2025 8th World Congress of Pediatric Surgery

Mahmoud Tarek ¹, Ahmed Abdelnaby ², Gamal Eltagy ¹, Aly Shalaby ¹

¹ Cairo University Faculty of Medicine, Pediatric Surgical Division, Cairo University Specialized Pediatric Hospital, Egypt
² Pediatric Surgery Department, Cairo University

ABSTRACT

Background: Intussusception is a common cause of intestinal obstruction in children. Treatment in early cases is non-surgical including hydrostatic or pneumatic reduction, adjuvant corticosteroids can be added to increase the success rate of reduction. Dexamethasone is a long rapidly acting corticosteroid. In this study we aim to evaluate its efficacy in its high and low doses to minimize the need for surgical treatment.

Methods: A controlled clinical trial conducted on patients divided into three groups, group (A) low dose dexamethasone, group (B) high dose dexamethasone and group (C) normal saline. Patients presenting with early symptoms were selected and underwent up to 3 trials of pneumatic reduction if the first and second trials were unsuccessfull. Dexamethasone was given once before the first trial only.

Results: The study involved 101 patients from January 2023 to December 2023, 34 patients in group (A), 34 in group (B) and 33 in group (C). Across all trials, a total of 70 patients (69.3%) achieved success; 82.4% of group A, 88.2% of group B, achieved success and 36.4% of group C. 64 out of 70 patients (91.4%) were successfull from the first trial. We found a statistically significant increase in success rate among groups taking dexamethasone either in low or high doses and the group taking saline with no significant difference comparing low with high dose dexamethasone.

Conclusion: The use of dexamethasone before pneumatic reduction of intussusception is effective in avoiding surgical management. More studies should be conducted to be used before every trial.