treatment
Last reviewed 01/2018
The treatment of choice is reduction by barium enema under radiological control. The enema is simultaneously a method of imaging and of treatment. Hydrostatic reduction with oxygen has been used in some centres. About 10% recur if they are reduced in this way.
Note that a barium enema is contraindicated if there are features of perforation or generalised peritonitis. A relative contraindication is the length of the history - more than 24 hours may be too long.
Surgical indications include:
- child under 3 months or over 2 years
- clinical signs of peritonitis
- gross dehydration
- failure of medical treatment, or recurrence after medical treatment
Surgical reduction has a recurrence rate of about 3%, resection is said to remove the risk of recurrence.