Intramural or subserosal gas in small bowel intussusceptions:Indications for surgery?

Objective To observe the presence of intramural or subserosal gas in small bowel intussusception,and to evaluate their correlation with successful reducibility.Methods Ultrasonic findings of 34 patients with small bowel intussusception were retrospectively reviewed and analyzed.Results Among 34 patients with small bowel intussusceptions,successful reducibility was obtained in 23 patients(67.65%) by conservative treatment or ultrasound guided hydrostatic reduction,in 11(32.35%) by surgical treatment.In 10 patients with intramural gas,conservative treatment or ultrasound guided hydrostatic reduction failed in 7(7/10,70.00%),while in 12 intussusceptions with subserosal gas,conservative treatment or ultrasound guided hydrostatic reduction failed in 8(8/12,66.67%) patients,and surgical treatment was performed and succeeded in these 15 patients.The presence of intramural or subserosal gas predicted a lower chance of reduction by conservative treatment or ultrasound guided hydrostatic reduction(P0.05).Conclusion The presence of intramural or subserosal gas in patients with small bowel intussusception significantly decreased the chance of reduction by conservative treatment or ultrasound guided hydrostatic reduction,indicating the necessity of surgical operation.