What is the role of air enema in the treatment of intussusception?

Updated: Dec 20, 2018
  • Author: A Alfred Chahine, MD; Chief Editor: Carmen Cuffari, MD  more...
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Air enema is the treatment of choice in many institutions. The risk of major complications with this technique is small. Its success is decreased, as with other reducing agents, in patients with small bowel intussusceptions and in those with prolapsing intussusceptions. When performing a therapeutic enema, the recommended pressure of air insufflation should not exceed 120 cm of water. When using barium or water-soluble contrast, the column of contrast should not exceed 100 cm above the level of the buttocks.

Traditionally, an attempt was not considered successful until the reducing agent, whether air, barium, or water-soluble contrast, was observed refluxing back into the terminal ileum, but evidence has shown that this is not entirely necessary. Most intussusceptions that failed to show reflux into the ileum were due to either an edematous or competent ileocecal valve. When these patients were explored, they displayed a completely reduced intussusception. According to this study, a patient who becomes asymptomatic after nonoperative reduction that fails to show reflux of the reducing agent into the ileum can safely be observed. [24]

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