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Intussusception is the most common abdominal emergency of early childhood and is usually idiopathic. The vast majority of cases (80%) occur in children less than 2 years, with the most frequent age range being 5-10 months.

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Bottom Line Recommendations English (5) French (1) All (6)

Bottom Line Recommendations: Intussusception

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Timmons Z, Bulloch B & TREKK Network

The purpose of this document is to provide healthcare professionals with key facts and recommendations for the diagnosis and management of intussusception in children. Original (Version 1.0) published online in 2016. Update (Version 2.0) published online in June 2018.

Care Pathway: Intussusception Care Pathway

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SickKids

The purpose of this pathway is to assist the health care team with clinical decisions regarding the management of a patient with intussusception.

Quick Glance: Recommendations de Base: Invagination

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Timmons Z, Bulloch B & TREKK Networkd

The purpose of this document is to provide healthcare professionals with key facts and recommendations for the diagnosis and treatment of intussusception in children.

Bottom Line Recommendations: Intussusception

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Timmons Z, Bulloch B & TREKK Networkd

The purpose of this document is to provide healthcare professionals with key facts and recommendations for the diagnosis and treatment of intussusception in children.

Bottom Line: Intussusception

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Princess Margaret Hospital for Children

This general summary aids in the diagnosis and management of intussusception.

Recommendations de Base: Invagination

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Timmons Z, Bulloch B and TREKK Network

Recommandations de base pour le diagnostic et le traitement de l'invagination. Original (version 1.0) publié en ligne en fevrier 2016. Mise à jour (version 2.0) publiée en ligne juillet 2018.

Bottom Line Recommendations: Intussusception

Download

Timmons Z, Bulloch B & TREKK Network

The purpose of this document is to provide healthcare professionals with key facts and recommendations for the diagnosis and management of intussusception in children. Original (Version 1.0) published online in 2016. Update (Version 2.0) published online in June 2018.

Recommendations de Base: Invagination

Download

Timmons Z, Bulloch B and TREKK Network

Recommandations de base pour le diagnostic et le traitement de l'invagination. Original (version 1.0) publié en ligne en fevrier 2016. Mise à jour (version 2.0) publiée en ligne juillet 2018.

Care Pathway: Intussusception Care Pathway

Visit

SickKids

The purpose of this pathway is to assist the health care team with clinical decisions regarding the management of a patient with intussusception.

Quick Glance: Recommendations de Base: Invagination

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Timmons Z, Bulloch B & TREKK Networkd

The purpose of this document is to provide healthcare professionals with key facts and recommendations for the diagnosis and treatment of intussusception in children.

Bottom Line Recommendations: Intussusception

Visit

Timmons Z, Bulloch B & TREKK Networkd

The purpose of this document is to provide healthcare professionals with key facts and recommendations for the diagnosis and treatment of intussusception in children.

Bottom Line: Intussusception

Visit

Princess Margaret Hospital for Children

This general summary aids in the diagnosis and management of intussusception.

Clinical guidelines English (4) French All (4)

Clinical Practice Guideline: European Society for Paediatric Infectious Diseases consensus recommendations for rotavirus vaccination in Europe: update 2014

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Vesikari T, Van Damme P, Giaquinto C, Dagan R, Guarino A, Szajewska H, Usonis...

This guideline aims to provide policy makers of European countries with the information and tools to assist in decision making on rotavirus vaccination policy with the new consensus recommendations.

Clinical Practice Guideline: Japanese guidelines for the management of intussusception in children, 2011

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Ito Y, Kusakawa I, Murata Y, Ukiyama E, Kawase H, Kamagata S, Ueno S, Osamura...

This guideline aims to help clinicians promptly diagnose intussusception, initiate appropriate treatment as early as possible, and to protect intussuscepted children.

Clinical Practice Guideline: Data Form: Appendix from article, "Risk of intussusception after monovalent rotavirus vaccination"

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Weihmiller SN, Buonomo C, Bachur R,

This checklist assists in the detection of intussusception risk following monovalent rotavirus vaccination.

Clinical Practice Guideline: Recommendations for the use of rotavirus vaccines in infants

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Canadian Paediatric Society

These guidelines provide recommendations for the use of rotavirus vaccine for infants in Canada, and summarize information on the disease, epidemiology, as well as the safety and efficacy of vaccines currently authorized for the prevention of rotavirus disease in Canada.

Clinical Practice Guideline: European Society for Paediatric Infectious Diseases consensus recommendations for rotavirus vaccination in Europe: update 2014

Visit

Vesikari T, Van Damme P, Giaquinto C, Dagan R, Guarino A, Szajewska H, Usonis...

This guideline aims to provide policy makers of European countries with the information and tools to assist in decision making on rotavirus vaccination policy with the new consensus recommendations.

Clinical Practice Guideline: Japanese guidelines for the management of intussusception in children, 2011

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Ito Y, Kusakawa I, Murata Y, Ukiyama E, Kawase H, Kamagata S, Ueno S, Osamura...

This guideline aims to help clinicians promptly diagnose intussusception, initiate appropriate treatment as early as possible, and to protect intussuscepted children.

Clinical Practice Guideline: Data Form: Appendix from article, "Risk of intussusception after monovalent rotavirus vaccination"

Visit

Weihmiller SN, Buonomo C, Bachur R,

This checklist assists in the detection of intussusception risk following monovalent rotavirus vaccination.

Clinical Practice Guideline: Recommendations for the use of rotavirus vaccines in infants

Visit

Canadian Paediatric Society

These guidelines provide recommendations for the use of rotavirus vaccine for infants in Canada, and summarize information on the disease, epidemiology, as well as the safety and efficacy of vaccines currently authorized for the prevention of rotavirus disease in Canada.

Summaries of systematic reviews English (6) French All (6)

Cochrane Summary: Management of intussusception in children

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Gluckman S, Karpelowsky J, Webster AC, McGee RG

Objective: To assess the safety and effectiveness of non-surgical and surgical approaches in the management of intussusception in children.

Cochrane Summary: Vaccines for preventing rotavirus diarrhoea: vaccines in use

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Soares-Weiser K, Maclehose H, Bergman H, Ben-Aharon I, Nagpal S, Goldberg E, ...

Objective: To evaluate rotavirus vaccines approved for use (RV1, RV5, and LLR) for preventing rotavirus diarrhoea.

Evidence Summary: Towards evidence based medicine for paediatricians. Question 3. Does the administration of glucagon improve the rate of radiological reduction in children with acute intestinal intussusception?

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Cachat F, Ramseyer P,

This summary examines the relationship between glucagon and the rate of radiological reduction for acute intestinal intussusception.

Evidence Summary: Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 2: Can emergency physicians safely rule in or rule out paediatric intussusception in the emergency department using bedside ultrasound?

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Raymond-Dufresne , Ghanayem H,

This summary investigates the diagnostic use of bedside ultrasound for paediatric intussusception in the emergency department.

Evidence Summary: Best evidence topic reports. Bet 4. Role of plain abdominal radiograph in the diagnosis of intussusception

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Broomfield D, Maconochie I,

This summary investigates the role of plain abdominal radiograph in the diagnosis of intussusception

Evidence Summary: Clinically suspected intussusception in children: evidence based review and self-assessment module

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Applegate KE,

This summary uses case examples to review the current evidence for the management of children with clinically suspected intussusception.

Cochrane Summary: Management of intussusception in children

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Gluckman S, Karpelowsky J, Webster AC, McGee RG

Objective: To assess the safety and effectiveness of non-surgical and surgical approaches in the management of intussusception in children.

Cochrane Summary: Vaccines for preventing rotavirus diarrhoea: vaccines in use

Visit

Soares-Weiser K, Maclehose H, Bergman H, Ben-Aharon I, Nagpal S, Goldberg E, ...

Objective: To evaluate rotavirus vaccines approved for use (RV1, RV5, and LLR) for preventing rotavirus diarrhoea.

Evidence Summary: Towards evidence based medicine for paediatricians. Question 3. Does the administration of glucagon improve the rate of radiological reduction in children with acute intestinal intussusception?

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Cachat F, Ramseyer P,

This summary examines the relationship between glucagon and the rate of radiological reduction for acute intestinal intussusception.

Evidence Summary: Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 2: Can emergency physicians safely rule in or rule out paediatric intussusception in the emergency department using bedside ultrasound?

Visit

Raymond-Dufresne , Ghanayem H,

This summary investigates the diagnostic use of bedside ultrasound for paediatric intussusception in the emergency department.

Evidence Summary: Best evidence topic reports. Bet 4. Role of plain abdominal radiograph in the diagnosis of intussusception

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Broomfield D, Maconochie I,

This summary investigates the role of plain abdominal radiograph in the diagnosis of intussusception

Evidence Summary: Clinically suspected intussusception in children: evidence based review and self-assessment module

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Applegate KE,

This summary uses case examples to review the current evidence for the management of children with clinically suspected intussusception.

Systematic reviews English (14) French All (14)

Systematic Review: Management for intussusception in children

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Gluckman, S, Karpelowsky, J, Webster, AC & McGee RG

Objective: To assess the safety and effectiveness of non-surgical and surgical approaches in the management of intussusception in children.

Systematic Review: Comparative Effectiveness of Imaging Modalities for the Diagnosis and Treatment of Intussusception: A Critically Appraised Topic

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Carroll AG, Kavanagh RG, Ni Leidhin C, Cullinan NM, Lavelle LP, Malone DE

The purpose of this study was to critically appraise and compare the diagnostic performance of imaging modalities that are used for the diagnosis of intussusception and methods used in the treatment of ileocolic intussusception.

Systematic Review: Comparison of safety and efficacy of image-guided enema reduction techniques for paediatric intussusception: A review of the literature

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Chew R, Ditchfield M, Paul E, Goergen SK

The aim of this study was to review the literature regarding the efficacy and safety of fluroscopically guided pneumatic reduction (FGPR) compared to ultrasound (US) guided intussusception reduction (USGIR) techniques for paediatric intussusception treatment.

Cochrane Systematic Review: Management for intussusception in children

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Gluckman S, Karpelowsky J, Webster AC, McGee RG

Objective: To assess the safety and effectiveness of non-surgical and surgical approaches in the management of intussusception in children.

Systematic Review: Risk of intussusception following rotavirus vaccination: An evidence based meta-analysis of cohort and case-control studies

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Kassim P, Eslick GD

A meta-analysis was performed to summarise available evidence and to give an overall risk of developing intussusception from case-control and cohort studies for all rotavirus vaccines that have been manufactured up to date.

Systematic Review: Risk of Intussusception After Rotavirus Vaccination

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Koch J, Harder T, von Kries R, Wichmann O

This study reviewed the literature for self-controlled case series studies on the risk of intussusception after RV vaccination.

Systematic Review: What Measures Improve Reduction of Intussusception in Pediatric Patients?

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Long B, April MD

This study reviewed randomized clinical trials comparing contrast media, imaging modalities, pharmacologic adjuvants, protocols for delayed repeated enema, surgical approaches, or other curative techniques for intussusception management.

Systematic Review: Systematic review shows that pathological lead points are important and frequent in intussusception and are not limited to infants

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Fiegel H, Gfroerer S, Rolle U

A systematic literature review was performed from 1998 to 2016 to evaluate the incidence and types of pathalogical lead points in paediatric intussusception.

Systematic Review: Meta-analysis of Air Versus Liquid Enema for Intussusception Reduction in Children

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Sadigh G, Zou KH, Razavi SA, Khan R, Applegate KE

The purpose of this study was to assess the effectiveness and safety of air versus liquid enema reduction in the treatment of intussusception in children.

Systematic Review: Recurrence rates after intussusception enema reduction: a meta-analysis

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Gray MP, Li SH, Hoffmann RG, Gorelick MH,

Objective: To conduct a systematic review and meta-analysis to estimate overall, 24-hour, and 48-hour recurrence rates after enema reduction in children.

Systematic Review: An institutional analysis and systematic review with meta-analysis of pneumatic versus hydrostatic reduction for pediatric intussusception

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Beres AL, Baird R,

This paper conducts a review and a critical appraisal to find the optimal intussusception reduction technique to maximize success while minimizing morbidity.

Systematic Review: Postoperative intussusceptions in children and infants: a systematic review

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Yang G, Wang X, Jiang W, Ma J, Zhao J, Liu W,

Objective: To evaluate the clinical features of postoperative intussusception through a literature review.

Cochrane Systematic Review: Vaccines for preventing rotavirus diarrhoea: vaccines in use

Visit

Soares-Weiser K, Maclehose H, Bergman H, Ben-Aharon I, Nagpal S, Goldberg E, ...

Objective: To evaluate rotavirus vaccines approved for use (RV1, RV5, and LLR) for preventing rotavirus diarrhoea.

Comparative Effectiveness Review: Intussusception in children: cost-effectiveness of ultrasound vs diagnostic contrast enema

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Bucher BT, Hall BL, Warner BW, Keller MS,

Objective: To compare the cost-effectiveness of different imaging strategies for the diagnosis of pediatric intussusception using a decision analytic model.

Systematic Review: Management for intussusception in children

Visit

Gluckman, S, Karpelowsky, J, Webster, AC & McGee RG

Objective: To assess the safety and effectiveness of non-surgical and surgical approaches in the management of intussusception in children.

Systematic Review: Comparative Effectiveness of Imaging Modalities for the Diagnosis and Treatment of Intussusception: A Critically Appraised Topic

Visit

Carroll AG, Kavanagh RG, Ni Leidhin C, Cullinan NM, Lavelle LP, Malone DE

The purpose of this study was to critically appraise and compare the diagnostic performance of imaging modalities that are used for the diagnosis of intussusception and methods used in the treatment of ileocolic intussusception.

Systematic Review: Comparison of safety and efficacy of image-guided enema reduction techniques for paediatric intussusception: A review of the literature

Visit

Chew R, Ditchfield M, Paul E, Goergen SK

The aim of this study was to review the literature regarding the efficacy and safety of fluroscopically guided pneumatic reduction (FGPR) compared to ultrasound (US) guided intussusception reduction (USGIR) techniques for paediatric intussusception treatment.

Cochrane Systematic Review: Management for intussusception in children

Visit

Gluckman S, Karpelowsky J, Webster AC, McGee RG

Objective: To assess the safety and effectiveness of non-surgical and surgical approaches in the management of intussusception in children.

Systematic Review: Risk of intussusception following rotavirus vaccination: An evidence based meta-analysis of cohort and case-control studies

Visit

Kassim P, Eslick GD

A meta-analysis was performed to summarise available evidence and to give an overall risk of developing intussusception from case-control and cohort studies for all rotavirus vaccines that have been manufactured up to date.

Systematic Review: Risk of Intussusception After Rotavirus Vaccination

Visit

Koch J, Harder T, von Kries R, Wichmann O

This study reviewed the literature for self-controlled case series studies on the risk of intussusception after RV vaccination.

Systematic Review: What Measures Improve Reduction of Intussusception in Pediatric Patients?

Visit

Long B, April MD

This study reviewed randomized clinical trials comparing contrast media, imaging modalities, pharmacologic adjuvants, protocols for delayed repeated enema, surgical approaches, or other curative techniques for intussusception management.

Systematic Review: Systematic review shows that pathological lead points are important and frequent in intussusception and are not limited to infants

Visit

Fiegel H, Gfroerer S, Rolle U

A systematic literature review was performed from 1998 to 2016 to evaluate the incidence and types of pathalogical lead points in paediatric intussusception.

Systematic Review: Meta-analysis of Air Versus Liquid Enema for Intussusception Reduction in Children

Visit

Sadigh G, Zou KH, Razavi SA, Khan R, Applegate KE

The purpose of this study was to assess the effectiveness and safety of air versus liquid enema reduction in the treatment of intussusception in children.

Systematic Review: Recurrence rates after intussusception enema reduction: a meta-analysis

Visit

Gray MP, Li SH, Hoffmann RG, Gorelick MH,

Objective: To conduct a systematic review and meta-analysis to estimate overall, 24-hour, and 48-hour recurrence rates after enema reduction in children.

Systematic Review: An institutional analysis and systematic review with meta-analysis of pneumatic versus hydrostatic reduction for pediatric intussusception

Visit

Beres AL, Baird R,

This paper conducts a review and a critical appraisal to find the optimal intussusception reduction technique to maximize success while minimizing morbidity.

Systematic Review: Postoperative intussusceptions in children and infants: a systematic review

Visit

Yang G, Wang X, Jiang W, Ma J, Zhao J, Liu W,

Objective: To evaluate the clinical features of postoperative intussusception through a literature review.

Cochrane Systematic Review: Vaccines for preventing rotavirus diarrhoea: vaccines in use

Visit

Soares-Weiser K, Maclehose H, Bergman H, Ben-Aharon I, Nagpal S, Goldberg E, ...

Objective: To evaluate rotavirus vaccines approved for use (RV1, RV5, and LLR) for preventing rotavirus diarrhoea.

Comparative Effectiveness Review: Intussusception in children: cost-effectiveness of ultrasound vs diagnostic contrast enema

Visit

Bucher BT, Hall BL, Warner BW, Keller MS,

Objective: To compare the cost-effectiveness of different imaging strategies for the diagnosis of pediatric intussusception using a decision analytic model.

Key studies English (39) French All (39)

Key Study: The role of dexamethasone in decreasing early recurrence of acute intussusception in children: A retrospective study

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Efrati Y, Klin B, Kozer E, Abu-Kishk I

The purpose of this study was to examine the role of dexamethasone in decreasing early RI.

Key Study: Success rate of pneumatic reduction of intussusception with and without sedation

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Feldman O, Weiser G, Hanna M, Devir O, Balla U, Johnson DW, Kozer E, Shavit I

The aim of this study was to evaluate the success rate of pneumatic reduction of intussusception with and without sedation.

Key Study: Assessing the risk of intussusception and rotavirus vaccine safety in Canada

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Hawken S, Ducharme R, Rosella LC, Benchimol EI, Langley JM, Wilson K, Crowcro...

Objective: To determine the incidence of intussusception among infants in Canada both before and adter introduction of rotavirus immunization programs.

Key Study: Risk factors associated with intestinal necrosis in children with failed non-surgical reduction for intussusception

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Huang HY, Huang XZ, Han YJ, Zhu LB, Huang KY, Lin J, Li ZR

Objective: This study aimed to investigate the risk factors associated with intestinal necrosis in pediatric patients with failed non-surgical reduction for intussusception.

Key Study: Intussusception reduction: Effect of air vs. liquid enema on radiation dose

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Kaplan SL, Magill D, Felice MA, Edgar JC, Anupindi SA, Zhu X

Objective: We test the hypothesis that air enema reduction of ileocolic intussusception results in lower radiation dose than liquid contrast enema independent of fluroscopy time. We describe a role for automatic exposure control in this dose difference.

Key Study: Positive guaiac and bloody stool are poor predictors of intussusception

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Kimia AA, Williams S, Hadar PN, Landschaft A, Porter J, Bachur RG

Objective: To assess the predictive value of GI bleeding (positive guaiac test, bloody stool and rectal bleeding) in evaluation of intussusception.

Key Study: A Practice Guideline for Postreduction Management of Intussusception of Children in the Emergency Department

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Kwon H, Lee JH, Jeong JH, Yang HR, Kwak YH, Kim DK, Kim K

Objective: The aim of this study was to evaluate the effects of a practice guideline of postreduction management of intussusception in children on the length of stay (LOS) from reduction in the pediatric emergency department (PED) and on the incidence of recurrence.

Key Study: Is Intussusception a Middle-of-the-Night Emergency?

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Lampl BS, Glaab J, Ayyala RS, Kanchi R, Ruzal-Shapiro CB

Objectives: Intussusception is the most common abdominal emergency in pediatric patients aged 6 months to 3 years. There is often a delay in diagnosis, as the presentation can be confused for viral gastroenteritis. Given this scenario, we questioned the practice of performing emergency reductions in children during the night when minimal support staff are available. Pneumatic reduction is not a benign procedure, with the most significant risk being bowel perforation. We performed this analysis to determine whether it would be safe to delay reduction in these patients until normal working hours when more support staff are available.

Key Study: Maternal smoking as a risk factor for childhood intussusception

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Nakahara Y, Yorifuji T, Kubo T, Doi H

Objective: The association between the risk of hospital admission for intussusception and maternal smoking was examined, using a nationwide population-based longitudinal survey begun in Japan in 2010.

Key Study: Age at presentation and management of pediatric intussusception: A Pediatric Health Information System database study

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Savoie KB, Thomas F, Nouer SS, Langham MR Jr, Huang EY

Objective: To determine whether older children are at greater risk of requiring operative intervention and/or having pathology causing lead points, such that enema reduction should not be attempted.

Key Study: Comparison of Lactic Acid Levels in Children with Suspected and Confirmed Intussusception

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Tamas V, Ishimine P

Objective: We present a case series comparing lactic acid levels in children with suspected and confirmed intussusception.

Key Study: Effects of esketamine sedation compared to morphine analgesia on hydrostatic reduction of intussusception: A case-cohort comparison study

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van de Bunt JA, Veldhoen ES, Nievelstein RAJ, Hulsker CCC, Schouten ANJ, van ...

The aim of this study was to compare hydrostatic reduction using morphine analgesia compared to procedural sedation with eskatamine in terms of success rate, adverse events, and duration for reduction.

Key Study: Twenty years' experience for reduction of ileocolic intussusceptions by saline enema under sonography control

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Flaum V, Schneider A, Gomes Ferreira C, Philippe P, Sebastia Sancho C, Lacreu...

The purpose of this study was to present our 20 years' experience in intussusception reductions using saline enema under ultrasound control and to assess its efficiency and safety.

Key Study: Ultrasound-guided reduction of intussusception: a safe and effective method performed by pediatric surgeons

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Gfroerer S, Fiegel H, Rolle U

This retrospective study evaluates the efficacy and safety of ultrasound in diagnosis and treatment of intussusception performed solely by pediatric surgeons.

Key Study: Failed Intussusception Reduction in Children: Correlation Between Radiologic, Surgical, and Pathologic Findings

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Ntoulia A, Tharakan SJ, Reid JR, Mahboubi S

The objective of this study was to identify causes of irreducible intussusception after contrast enema and to correlate imaging findings with surgical and histopathological findings.

Key Study: Utility of hospital admission for pediatric intussusceptions

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Puckett Y, Greenspon J, Fitzpatrick C, Vane D, Bansal S, Rice M, Chatoorgoon K

The objective of this study was to examine whether post-reduction admission to hospital is required in patients diagnosed with intussusception.

Key Study: Abdominal radiography is not necessary in children with intussusception

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Tareen F, Mc Laughlin D, Cianci F, Hoare SM, Sweeney B, Mortell A, Puri P

The aim of this study was to investigate the benefit of abdominal radiography in intussusception by determining diagnostic accuracy and analysing correlation of AR findings with outcome.

Key Study: Intussusception Rates Before and After the Introduction of Rotavirus Vaccine

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Tate JE, Yen C, Steiner CA, Cortese MM, Parashar UD

This study examined trends in intussusception hospitalizations before (2000-2005) and after (2007-2013) rotavirus vaccine introduction to assess whether this observed temporal risk translates into more hospitalized cases at the population level.

Key Study: Clinical and Ultrasonographic Features of Secondary Intussusception in Children

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Zhang Y, Dong Q, Li SX, Ren WD, Shi B, Bai YZ, Zhang SC, Zheng LQ

The aim of this study was to review the ultrasonographic features of secondary intussusception (SI) in children and assess the value of ultrasound in the diagnosis of pediatric SI.

Key Study: Fluoroscopy-guided hydrostatic reduction of intussusception in infancy: role of pharmacological premedication

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Esposito, F, Ambrosio, C, De Fronzo, S, Panico, MR, D'Aprano, M, Giugliano, A...

Objective: To verify the presence of a possible correlation between pharmacological premedication and the percentage of hydrostatic reduction of intussusception in paediatric patients.

Key Study: Delayed repeat enemas are safe and cost-effective in the management of pediatric intussusception

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Lautz TB, Thurm CW, Rothstein DH,

Objective: To compare outcomes between delayed repeat enema (DRE) and immediate surgery (IS) in children with ileocolic intussusception who fail initial enema reduction.

Key Study: The Frequency of Postreduction Interventions After Successful Enema Reduction of Intussusception

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Lessenich, EM, Kimia, AA, Mandeville, K, Li, J, Landschaft, A, Tsai, A, Bachu...

Objectives: To determine the frequency of postreduction, hospital-level interventions among children with successful reduction of ileocolic intussusception and identify factors that predict the need for such interventions.

Key Study: Improving Quality and Efficiency for Intussusception Management After Successful Enema Reduction

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Raval MV, Minneci PC, Deans KJ, Kurtovic KJ, Dietrich A, Bates DG, Rangel SJ,...

The purpose of this project was to implement a protocol facilitating discharge from the emergency department (ED) after successful radiologic ileocolic intussusception reduction in a pediatric referral centre.

Key Study: Association between medication and intestinal intussusceptionin children: a case-crossover study

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Vega Garca, L, Fuentes-Leonarte, V, Tenas, JM, Correcher Medina, P, Arias Ari...

Objective: To assess the association between the appearance of intussusception in children and medication intake in the immediately preceding period (2-15 days).

Key Study: Childhood intussusception: 17-year experience at a tertiary referral centre in Hong Kong

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Wong CW, Chan IH, Chung PH, Lan LC, Lam WM, Wong KK, Tam PK

Objective: To review all paediatric patients with intussusception over the last 17 years.

Key Study: Comparative outcome analysis of the management of pediatric intussusception with or without surgical admission

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Beres AL, Baird R, Fung E, Hsieh H, Abou-Khalil M, Ted Gerstle J,

Objective: To show that pediatric intussusception could be managed with discharge from the emergency department after successful reduction without increasing morbidity, potentially yielding significant health care cost savings.

Key Study: Intussusception revisited: is immediate on-site surgeon availability at the time of reduction necessary?

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Nguyen HN, Kan JH, Guillerman RP, Cassady CI,

Objective: To assess the utilization of immediate surgical services at the time of radiologic intussusception reduction.

Key Study: Risk of intussusception after monovalent rotavirus vaccination

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Weintraub ES, Baggs J, Duffy J, Vellozzi C, Belongia EA, Irving S, Klein NP, ...

This study examines the possiblilty of a small increase in risk of intussusception after monovalent rotavirus vaccination in a population in the United States.

Key Study: Management of the child after enema-reduced intussusception: hospital or home?

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Chien M, Willyerd FA, Mandeville K, Hostetler MA, Bulloch B,

Objectives: To determine the rate and timing of recurrent intussusception after successful enema reduction and describe any associated complications.

Key Study: Antibiotics administration before enema reduction of intussusception: is it necessary?

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Al-Tokhais T, Hsieh H, Pemberton J, Elnahas A, Puligandla P, Flageole H,

Objective: To determine whether using antibiotics before reduction provided any improvement in outcomes.

Key Study: Intussusception: clinical presentations and imaging characteristics

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Mandeville K, Chien M, Willyerd FA, Mandell G, Hostetler MA, Bulloch B,

Objectives: To determine the prevalence of clinical findings associated with intussusception based on age and to evaluate the test characteristics of the presence of air in the ascending colon on abdominal radiographs and the effectiveness of ultrasound in diagnosing intussusception.

Key Study: Diagnosis of intussusception by physician novice sonographers in the emergency department

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Riera A, Hsiao AL, Langhan ML, Goodman TR, Chen L,

This study investigates the performance characteristics of bedside emergency department (ED) ultrasonography by nonradiologist physician sonographers in the diagnosis of ileocolic intussusception in children.

Key Study: Management of childhood intussusception after reduction by enema

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Gilmore AW, Reed M, Tenenbein M,

This paper describes the utility of emergency department (ED)/outpatient management after enema reduction for childhood intussusception.

Key Study: Risk stratification of children being evaluated for intussusception

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Weihmiller SN, Buonomo C, Bachur R,

Objectives: To determine predictive clinical criteria and develop a decision tree to risk-stratify children with possible intussusception.

Key Study: Enema-reduced intussusception management: is hospitalization necessary?

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Herwig K, Brenkert T, Lose JD,

Objectives: To describe the demographic and clinical characteristics of hospitalized children with enema-reduced intussusception and to determine the necessity of hospitalization.

Key Study: The role of abdominal radiography in the diagnosis of intussusception when interpreted by pediatric emergency physicians

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Morrison J, Lucas N, Gravel J,

Objective: To evaluate the sensitivity and specificity of abdominal x-rays in the diagnosis of intussusception when interpreted by pediatric emergency physicians.

Key Study: Sonography of pediatric small-bowel intussusception: differentiating surgical from nonsurgical cases

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Munden MM, Bruzzi JF, Coley BD, Munden RF,

Objective: To determine whether there are clinical or sonographic findings that can be used to differentiate benign self-limited small-bowel intussusception from pathologic small-bowel intussusception that necessitates surgical intervention.

Key Study: Childhood intussusception: a comparative study of nonsurgical management

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Hadidi AT, El Shal N,

Objectives: To compare air reduction, barium reduction under fluoroscopy, and saline reduction under ultrasound guidance for diagnosis and treatment of intussusception involved in 147 patients.

Key Study: Patterns of recurrence of intussusception in children: a 17-year review

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Daneman A, Alton DJ, Lobo E, Gravett J, Kim P, Ein SH,

Objectives: To determine whether changes in management have affected the rate and patterns of recurrence as well as long-term outcome in children with multiple recurrences.

Key Study: The role of dexamethasone in decreasing early recurrence of acute intussusception in children: A retrospective study

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Efrati Y, Klin B, Kozer E, Abu-Kishk I

The purpose of this study was to examine the role of dexamethasone in decreasing early RI.

Key Study: Success rate of pneumatic reduction of intussusception with and without sedation

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Feldman O, Weiser G, Hanna M, Devir O, Balla U, Johnson DW, Kozer E, Shavit I

The aim of this study was to evaluate the success rate of pneumatic reduction of intussusception with and without sedation.

Key Study: Assessing the risk of intussusception and rotavirus vaccine safety in Canada

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Hawken S, Ducharme R, Rosella LC, Benchimol EI, Langley JM, Wilson K, Crowcro...

Objective: To determine the incidence of intussusception among infants in Canada both before and adter introduction of rotavirus immunization programs.

Key Study: Risk factors associated with intestinal necrosis in children with failed non-surgical reduction for intussusception

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Huang HY, Huang XZ, Han YJ, Zhu LB, Huang KY, Lin J, Li ZR

Objective: This study aimed to investigate the risk factors associated with intestinal necrosis in pediatric patients with failed non-surgical reduction for intussusception.

Key Study: Intussusception reduction: Effect of air vs. liquid enema on radiation dose

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Kaplan SL, Magill D, Felice MA, Edgar JC, Anupindi SA, Zhu X

Objective: We test the hypothesis that air enema reduction of ileocolic intussusception results in lower radiation dose than liquid contrast enema independent of fluroscopy time. We describe a role for automatic exposure control in this dose difference.

Key Study: Positive guaiac and bloody stool are poor predictors of intussusception

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Kimia AA, Williams S, Hadar PN, Landschaft A, Porter J, Bachur RG

Objective: To assess the predictive value of GI bleeding (positive guaiac test, bloody stool and rectal bleeding) in evaluation of intussusception.

Key Study: A Practice Guideline for Postreduction Management of Intussusception of Children in the Emergency Department

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Kwon H, Lee JH, Jeong JH, Yang HR, Kwak YH, Kim DK, Kim K

Objective: The aim of this study was to evaluate the effects of a practice guideline of postreduction management of intussusception in children on the length of stay (LOS) from reduction in the pediatric emergency department (PED) and on the incidence of recurrence.

Key Study: Is Intussusception a Middle-of-the-Night Emergency?

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Lampl BS, Glaab J, Ayyala RS, Kanchi R, Ruzal-Shapiro CB

Objectives: Intussusception is the most common abdominal emergency in pediatric patients aged 6 months to 3 years. There is often a delay in diagnosis, as the presentation can be confused for viral gastroenteritis. Given this scenario, we questioned the practice of performing emergency reductions in children during the night when minimal support staff are available. Pneumatic reduction is not a benign procedure, with the most significant risk being bowel perforation. We performed this analysis to determine whether it would be safe to delay reduction in these patients until normal working hours when more support staff are available.

Key Study: Maternal smoking as a risk factor for childhood intussusception

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Nakahara Y, Yorifuji T, Kubo T, Doi H

Objective: The association between the risk of hospital admission for intussusception and maternal smoking was examined, using a nationwide population-based longitudinal survey begun in Japan in 2010.

Key Study: Age at presentation and management of pediatric intussusception: A Pediatric Health Information System database study

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Savoie KB, Thomas F, Nouer SS, Langham MR Jr, Huang EY

Objective: To determine whether older children are at greater risk of requiring operative intervention and/or having pathology causing lead points, such that enema reduction should not be attempted.

Key Study: Comparison of Lactic Acid Levels in Children with Suspected and Confirmed Intussusception

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Tamas V, Ishimine P

Objective: We present a case series comparing lactic acid levels in children with suspected and confirmed intussusception.

Key Study: Effects of esketamine sedation compared to morphine analgesia on hydrostatic reduction of intussusception: A case-cohort comparison study

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van de Bunt JA, Veldhoen ES, Nievelstein RAJ, Hulsker CCC, Schouten ANJ, van ...

The aim of this study was to compare hydrostatic reduction using morphine analgesia compared to procedural sedation with eskatamine in terms of success rate, adverse events, and duration for reduction.

Key Study: Twenty years' experience for reduction of ileocolic intussusceptions by saline enema under sonography control

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Flaum V, Schneider A, Gomes Ferreira C, Philippe P, Sebastia Sancho C, Lacreu...

The purpose of this study was to present our 20 years' experience in intussusception reductions using saline enema under ultrasound control and to assess its efficiency and safety.

Key Study: Ultrasound-guided reduction of intussusception: a safe and effective method performed by pediatric surgeons

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Gfroerer S, Fiegel H, Rolle U

This retrospective study evaluates the efficacy and safety of ultrasound in diagnosis and treatment of intussusception performed solely by pediatric surgeons.

Key Study: Failed Intussusception Reduction in Children: Correlation Between Radiologic, Surgical, and Pathologic Findings

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Ntoulia A, Tharakan SJ, Reid JR, Mahboubi S

The objective of this study was to identify causes of irreducible intussusception after contrast enema and to correlate imaging findings with surgical and histopathological findings.

Key Study: Utility of hospital admission for pediatric intussusceptions

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Puckett Y, Greenspon J, Fitzpatrick C, Vane D, Bansal S, Rice M, Chatoorgoon K

The objective of this study was to examine whether post-reduction admission to hospital is required in patients diagnosed with intussusception.

Key Study: Abdominal radiography is not necessary in children with intussusception

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Tareen F, Mc Laughlin D, Cianci F, Hoare SM, Sweeney B, Mortell A, Puri P

The aim of this study was to investigate the benefit of abdominal radiography in intussusception by determining diagnostic accuracy and analysing correlation of AR findings with outcome.

Key Study: Intussusception Rates Before and After the Introduction of Rotavirus Vaccine

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Tate JE, Yen C, Steiner CA, Cortese MM, Parashar UD

This study examined trends in intussusception hospitalizations before (2000-2005) and after (2007-2013) rotavirus vaccine introduction to assess whether this observed temporal risk translates into more hospitalized cases at the population level.

Key Study: Clinical and Ultrasonographic Features of Secondary Intussusception in Children

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Zhang Y, Dong Q, Li SX, Ren WD, Shi B, Bai YZ, Zhang SC, Zheng LQ

The aim of this study was to review the ultrasonographic features of secondary intussusception (SI) in children and assess the value of ultrasound in the diagnosis of pediatric SI.

Key Study: Fluoroscopy-guided hydrostatic reduction of intussusception in infancy: role of pharmacological premedication

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Esposito, F, Ambrosio, C, De Fronzo, S, Panico, MR, D'Aprano, M, Giugliano, A...

Objective: To verify the presence of a possible correlation between pharmacological premedication and the percentage of hydrostatic reduction of intussusception in paediatric patients.

Key Study: Delayed repeat enemas are safe and cost-effective in the management of pediatric intussusception

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Lautz TB, Thurm CW, Rothstein DH,

Objective: To compare outcomes between delayed repeat enema (DRE) and immediate surgery (IS) in children with ileocolic intussusception who fail initial enema reduction.

Key Study: The Frequency of Postreduction Interventions After Successful Enema Reduction of Intussusception

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Lessenich, EM, Kimia, AA, Mandeville, K, Li, J, Landschaft, A, Tsai, A, Bachu...

Objectives: To determine the frequency of postreduction, hospital-level interventions among children with successful reduction of ileocolic intussusception and identify factors that predict the need for such interventions.

Key Study: Improving Quality and Efficiency for Intussusception Management After Successful Enema Reduction

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Raval MV, Minneci PC, Deans KJ, Kurtovic KJ, Dietrich A, Bates DG, Rangel SJ,...

The purpose of this project was to implement a protocol facilitating discharge from the emergency department (ED) after successful radiologic ileocolic intussusception reduction in a pediatric referral centre.

Key Study: Association between medication and intestinal intussusceptionin children: a case-crossover study

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Vega Garca, L, Fuentes-Leonarte, V, Tenas, JM, Correcher Medina, P, Arias Ari...

Objective: To assess the association between the appearance of intussusception in children and medication intake in the immediately preceding period (2-15 days).

Key Study: Childhood intussusception: 17-year experience at a tertiary referral centre in Hong Kong

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Wong CW, Chan IH, Chung PH, Lan LC, Lam WM, Wong KK, Tam PK

Objective: To review all paediatric patients with intussusception over the last 17 years.

Key Study: Comparative outcome analysis of the management of pediatric intussusception with or without surgical admission

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Beres AL, Baird R, Fung E, Hsieh H, Abou-Khalil M, Ted Gerstle J,

Objective: To show that pediatric intussusception could be managed with discharge from the emergency department after successful reduction without increasing morbidity, potentially yielding significant health care cost savings.

Key Study: Intussusception revisited: is immediate on-site surgeon availability at the time of reduction necessary?

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Nguyen HN, Kan JH, Guillerman RP, Cassady CI,

Objective: To assess the utilization of immediate surgical services at the time of radiologic intussusception reduction.

Key Study: Risk of intussusception after monovalent rotavirus vaccination

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Weintraub ES, Baggs J, Duffy J, Vellozzi C, Belongia EA, Irving S, Klein NP, ...

This study examines the possiblilty of a small increase in risk of intussusception after monovalent rotavirus vaccination in a population in the United States.

Key Study: Management of the child after enema-reduced intussusception: hospital or home?

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Chien M, Willyerd FA, Mandeville K, Hostetler MA, Bulloch B,

Objectives: To determine the rate and timing of recurrent intussusception after successful enema reduction and describe any associated complications.

Key Study: Antibiotics administration before enema reduction of intussusception: is it necessary?

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Al-Tokhais T, Hsieh H, Pemberton J, Elnahas A, Puligandla P, Flageole H,

Objective: To determine whether using antibiotics before reduction provided any improvement in outcomes.

Key Study: Intussusception: clinical presentations and imaging characteristics

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Mandeville K, Chien M, Willyerd FA, Mandell G, Hostetler MA, Bulloch B,

Objectives: To determine the prevalence of clinical findings associated with intussusception based on age and to evaluate the test characteristics of the presence of air in the ascending colon on abdominal radiographs and the effectiveness of ultrasound in diagnosing intussusception.

Key Study: Diagnosis of intussusception by physician novice sonographers in the emergency department

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Riera A, Hsiao AL, Langhan ML, Goodman TR, Chen L,

This study investigates the performance characteristics of bedside emergency department (ED) ultrasonography by nonradiologist physician sonographers in the diagnosis of ileocolic intussusception in children.

Key Study: Management of childhood intussusception after reduction by enema

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Gilmore AW, Reed M, Tenenbein M,

This paper describes the utility of emergency department (ED)/outpatient management after enema reduction for childhood intussusception.

Key Study: Risk stratification of children being evaluated for intussusception

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Weihmiller SN, Buonomo C, Bachur R,

Objectives: To determine predictive clinical criteria and develop a decision tree to risk-stratify children with possible intussusception.

Key Study: Enema-reduced intussusception management: is hospitalization necessary?

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Herwig K, Brenkert T, Lose JD,

Objectives: To describe the demographic and clinical characteristics of hospitalized children with enema-reduced intussusception and to determine the necessity of hospitalization.

Key Study: The role of abdominal radiography in the diagnosis of intussusception when interpreted by pediatric emergency physicians

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Morrison J, Lucas N, Gravel J,

Objective: To evaluate the sensitivity and specificity of abdominal x-rays in the diagnosis of intussusception when interpreted by pediatric emergency physicians.

Key Study: Sonography of pediatric small-bowel intussusception: differentiating surgical from nonsurgical cases

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Munden MM, Bruzzi JF, Coley BD, Munden RF,

Objective: To determine whether there are clinical or sonographic findings that can be used to differentiate benign self-limited small-bowel intussusception from pathologic small-bowel intussusception that necessitates surgical intervention.

Key Study: Childhood intussusception: a comparative study of nonsurgical management

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Hadidi AT, El Shal N,

Objectives: To compare air reduction, barium reduction under fluoroscopy, and saline reduction under ultrasound guidance for diagnosis and treatment of intussusception involved in 147 patients.

Key Study: Patterns of recurrence of intussusception in children: a 17-year review

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Daneman A, Alton DJ, Lobo E, Gravett J, Kim P, Ein SH,

Objectives: To determine whether changes in management have affected the rate and patterns of recurrence as well as long-term outcome in children with multiple recurrences.