The purpose of this study was to determine the success rate of air reduction as the primary treatment of intussusception and whether the success of air reduction could be predicted by plain x-ray. The authors reviewed the medical records of 54 consecutive patients diagnosed with intussusception from Jan 2005 to Dec 2007 at the Department of Surgery, Masan Samsung Hospital. The natures of symptoms and findings of plain abdominal radiography performed in the emergency department (ED) were reviewed. Air reduction failed more frequently (26.3%) in patients who visited ED more than 24 hours after symptom onset (p=0.009). The mean duration of symptom for operated patients was longer than air reduction group (p=0.01). Also, 3/4 of patients having localized distension of small bowel in the left upper quadrant abdomen had unsuccessful air reduction (p=0.002). In conclusion, the time interval from symptom onset to arrival at ED and localized distension of small bowel in the left upper quadrant abdomen significantly increased the failure rate of air reduction.

This is a 20 year analysis of the problems associated with enterostomy formation, and closure. Forty-three stomas were established in 43 patients: 23 for anorectal malformations, 11 for Hirschsprung's diseases, 4 for necrotizing enterocolitis, 3 for multiple ileal atresias, 1 for volvulus neonatorum with perforation, and 1 for diaphragmatic hernia with colon perforation. Thirty boys and 13 girls were included (mean age 4.8 months). Stoma complications were encountered in 13 patients (30.2 %): stomal prolapse, stenosis, obstruction, paracolic hernia, retraction, dysfunction, and skin excoriation. Four patients (9.3 %) required stomal revision. Occurrence of complications was not related to age and primary disease, but sigmoid colostomy showed lower complication rate than transverse colostomy (20.0 % vs 42.9 %, p<0.05). There were five deaths but, only one (2.3 %) was directly related to the enterostomy complication. Twenty-one stomas were closed in our hospital and complications occurred in seven patients (33.3 %). The most common complication was wound sepsis in 5 children. In conclusion, because the significant morbidity of stomal formation still exists, refinements of the surgical technique seem to be required. Sigmoid loop colostomy is preferred whenever possible.