• Xiao Bing Tang, Shu Ting Liu, Qian Yun Wu, Yi Feng Li, Xin Ma, and Yu Zuo Bai.
• Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, China.
• Ann. Med. 2024 Dec 1; 56 (1): 24171812417181.

ObjectiveBowel perforation is a major, yet unstudied complication of ultrasound-guided hydrostatic enema reduction (UGHR). In this study, we aimed to explore the risk factors and determine the clinical characteristics of bowel perforation during UGHR for paediatric intussusception (P-UGHR).MethodsWe retrospectively analysed the medical records of patients who underwent UGHR for intussusception at our institution between January 2011 and December 2021. The patients were divided into the P-UGHR and no P-UGHR groups. Univariate and multivariate logistic regression analyses were performed to analyse the risk factors for P-UGHR, and the clinical characteristics of patients with P-UGHR were determined.ResultsThe final analysis included 4961 intussusception episodes. We identified 15 patients [eight male (53.3%); median age, 8.73 months; age range, 3-17 months] with P-UGHR. All P-UGHR cases involved colonic perforations without necrosis distal to the intussusception mass. The perforations were located in the ascending [40% (6/15)], transverse [46.7% (7/15)] or descending colon [13.3% (2/15)]. Age ≤10.5 months [odds ratio (OR), 3.636; 90% confidence interval (CI), 1.274-10.38; P = 0.043], bloody stools (OR, 4.189; 90% CI, 1.352-12.978; P = 0.037) and symptom duration >17.5 h (OR, 0.188; 90% CI, 0.053-0.666; P = 0.03) were independent risk factors for P-UGHR.ConclusionAge ≤10.5 months, bloody stools and symptom duration >17.5 h were independent risk factors for P-UGHR. Caution should be exercised during UGHR in patients aged ≤10.5 months, with bloody stools or symptom duration >17.5 h.

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