Ultrasound-Guided Versus Fluoroscopic Conservative Reduction of Intestinal Intussusception in Children: A Retrospective Comparative Study

<b>Introduction: </b>Intestinal intussusception is the most common form of acquired intestinal obstruction in childhood. Diagnostic errors reach 50%, and complications occur in up to 53.7% of cases. Pneumoirrigoscopy under fluoroscopic control (PIS) has been the standard conservative technique, but its radiation burden and single-attempt limitation prompted the development of ultrasound-guided hydroechocolonographic disinvagination (HEC). This study aimed to compare the clinical outcomes of HEC and PIS in paediatric intestinal intussusception.<br /> <b>Methods: </b>A retrospective comparative study of 132 children aged 2 months to 10 years treated at the Specialized Paediatric Surgical Clinic of Samarkand State Medical University between 2000 and 2023. The control group (CG, n=59; January 2000–December 2013) received conventional PIS; the study group (SG, n=73; January 2014–December 2023) underwent ultrasound-guided HEC, a radiation-free technique developed at our institution. Primary outcomes were the rate of successful conservative reduction (assessed per patient), length of hospital stay, and mortality. Chi-squared and Student’s t-tests were used; p<0.05 was considered significant.<br /> <b>Results: </b>The predominant age group was 6 months to 1 year (51.5%); males predominated (70.5%, p<0.001). The ileocaecal variant was found in 90.1% of patients. Successful conservative reduction was achieved in 53.4% (39/73) of the study group versus 39.0% (23/59) in the control group. Mean hospital stay was significantly shorter in the study group (2.5±0.66 vs 4.6±0.51 days, p<0.05). Group-specific mortality was 2.7% (2/73) in the SG versus 8.5% (5/59) in the CG.<br /> <b>Conclusion: </b>Ultrasound-guided HEC is a safe, effective, and radiation-free alternative to PIS, achieving a higher rate of conservative reduction, a significantly shorter hospital stay, and enabling multiple reduction attempts. Disease duration alone should not determine treatment modality; clinical condition and the absence of peritoneal signs must be considered jointly.

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