WOFAPS 2025 8th World Congress of Pediatric Surgery

Muhammad Taufan Fajri, Dewi Novitasari Arifin, Pramana Adhityo, Nabila Ardia Pramono, Rizkia Gustin Nurul Fatimah, Lanang Aditama, Petrus Gandi Purwosatrio, Hesti Gunarti, Akhmad Makhmudi, Andi Dwihantoro, Gunadi Gunadi

Gadjah Mada University

Purpose: Intussusception is a common cause of intestinal obstruction in pediatrics. Identifying risk factors for hydrostatic reduction failure as a non-operative management, enables early identification of cases that require early surgical intervention and prevents prolonged strangulation. We proposed a scoring system to predict hydrostatic reduction failure in pediatric intussusception.

Methods: We retrospectively analyzed 61 childrens with intussusception who underwent hydrostatic reduction. The study develop a scoring system based on: age, weight, vomiting, duration of symptoms, presence of currant jelly stool, abdominal distension, location of the mass, and pseudoportio sign.

Results: From total 61 patients, 23 (37.7%) successfully underwent hydrostatic reduction, 38 (62.3%) experienced failure. A significant association was found between failed hydrostatic reduction and the following factors: age ≤12 months (p=0.002), body weight ≤10 kg (p=0.001), vomiting (p=0.0006), duration of symptoms>48 hours (p=0.003), abdominal distension (p=0.001), mass location (p=0.00004), presence of currant jelly stool (p=0.00005), and the pseudoportio sign (p=0.001). Multivariate analysis indicated that symptoms lasting more than 48 hours (p=0.014;OR=17.34 [95% CI=1.76-170.45]), the presence of a left-sided mass (p=0.003;OR=17.74 [95% CI=2.66-118.17]), and the presence of currant jelly stool (p=0.029;OR=9.05 [95% CI=1.26-65.03]) were strongly associated with hydrostatic reduction failure. Prediction scores ranged from 0 to 3; Score of ≥2 indicated a higher possibility of reduction failure (p<0.000).

Conclusion: The duration of symptoms >48 hours, the presence of currant jelly stool, and a left-sided abdominal mass, are associated with the failure of hydrostatic reduction. This scoring system may help predict hydrostatic reduction failure in children with intussusception and guide the need for early surgical intervention.