ABSTRACT
The aim of this work was to study cases of spontaneous reduction of intussusception and their implication on the management and outcome. We routinely use ultrasound for diagnosis and hydrostatic reduction of intussusception with saline enema. The study included 16 patients who were admitted to the Pediatric Surgical Center, Faculty of Medicine, University of Alexandria during the period between January 1996 and October 2000 with the diagnosis of intussusception. They fulfilled the study criteria of spontaneous reduction. Details of the clinical picture were compared with the standard cases of intussusception together with correlation with ultrasound features before and after reduction. All cases were examined on admission and diagnosis of intussusception was confirmed by finding the characteristic target sign on ultrasound. During the period of preparation for hydrostatic reduction or during transport from another center, 12 cases showed evidence of spontaneous reduction, which was confirmed by ultrasound and observation. Hydrostatic reduction was attempted in 4 cases. Four cases showed faint target sign on ultrasound after trial of reduction and were considered questionable. Surgical exploration was performed and showed a reduced intussusception. Spontaneous reduction of intussusception is a possible though rare fate of childhood intussusception. It must be borne in mind to avoid unnecessary surgery in this peculiar subset of patients. The pseudotarget sign on ultrasound can be present for a short period after successful reduction of intussusception and is probably due to residual edema. Awareness, short period of observation and repeating sonography examination after 2 hours will avoid confusion in these cases