Treatment

• Initial steps: nasogastric decompression and fluid resuscitation

• Nonsurgical management (performed under continuous ultrasound or fluoroscopic guidance) [7]

  • Air enema: treatment of choice

  • Hydrostatic reduction: normal saline (or water-soluble contrast enema)

  • Observe for 24 hours post-reduction, as there is a small risk of perforation and recurrence is common during this period. [1]

• Surgical reduction

  • Indications [1]

    • When a pathological lead point is suspected

    • Failed conservative management [8]

    • Suspected gangrenous or perforated bowel

    • Critically ill patient (e.g., shock)

  • Open or laparoscopic method

    • Hutchinson maneuver: manual proximal bowel compression and reduction of intussusception

    • For necrotic bowel segments: resection and end-to-end anastomosis

Urgent intervention is necessary for intussusception to prevent potentially life-threatening complications.

• Small bowel obstruction

• Bowel gangrene, perforation, and peritonitis

The prognosis of intussusception depends on how quickly it is treated. Most cases may be treated successfully with conservative pneumatic insufflation or hydrostatic reduction. The absence of ischemia or necrotic bowel is associated with a good prognosis.

• Success rates for non-surgical reduction: 45–95%

• Rate of relapse in patients with non-surgical reduction: 4.5–10%