Preoperative Dexamethasone as an adjunct to increase the success rate of pneumatic reduction for primary idiopathic intussusception in children: A pilot Study

Purpose Intussusception is a common cause of intestinal obstruction in children. Cases presenting early can be managed non-surgically by hydrostatic or pneumatic reduction. Dexamethasone is a long rapidly acting corticosteroid with anti-inflammatory effects. In this pilot study we aimed to evaluate the feasibility of recruiting and randomizing children with intussusception, administer two different doses of Dexamethasone, record outcomes and aid in the power calculation for a formal randomized trial. Methods Patients diagnosed with intussusception and presenting with early symptoms were recruited and underwent up to 3 trials of pneumatic reduction if the first and second trials were unsuccessfull. Dexamethasone was given once before the first trial only. Patients were randomized to two groups: high and low-dose Dexamethasone. Results The study involved 68 patients from January 2023 to December 2023, 34 patients in group (A) and 34 in group (B). Across all trials, a total of 58 patients (85.3%) avoided surgery. The first trial had the best success rate of 77.9%, rates dropped signifiantly in trials 2 and 3. There was no statistical difference between groups A and B. Conclusion Recruitment, randomization and data collection were all feasible. Results seem to suggest a promising role for Dexamethasone in the primary reduction of intussusception which would translate in a decreased need for surgery. A randomized trial is recommended.