Intussusception surgery

Surgery is not the first-line treatment option for patients with intussusception. Surgery is usually reserved for patients with either unstable patient, intestinal perforation, peritonitis, a mass lesion and patients in whom medical therapy was completely unstable. Technique includes intravenous fluid resuscitation, nasogastric tube decompression and use of laparoscopy. Benefits of laparoscopy include accurate diagnosis, rapid recovery and minimal use of narcotic analgesia post-operatively.

• Indications of surgical intervention include:
  • Unstable patient
  • Stable patient: when non-operative reduction is completely unsuccessful
  • Intestinal perforation
  • Peritonitis
  • A mass lesion – Imaging shows a persistent focal filling defect^[1]
• Technique
  • Intravenous fluid resuscitation
  • Prophylactic antibiotics covering enteric flora
  • Nasogastric tube decompression if the patient has nausea and emesis
  • Pediatric surgeons prefer minimally invasive approach through laproscopy
  • Benefits of laproscopy are:^[2][3][4][5]
    • Laproscopic surgery allows accurate diagnosis and reduction of intussusception
    • Rapid recovery
    • Minimal use of narcotic analgesia post-operatively
  • Reduction is successful in most cases
  • Primary anastomosis is done if manual reduction is not successful
  • Primary anastomosis is also done if there is a pathologic lead point
• Recurrence can occurs is less than 1% cases^[6]

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