Essa 2011.

Methods	Study design: randomised controlled trial; 2‐arm study Study duration: August 2006 until July 2010
Participants	Setting: single‐centre study Location: Assuit University Children's Hospital, Egypt Health Status: "clinical features of intussusception" Number (treatment group/control group): 75 (40/35) Age: 5 to 24 months Sex (M/F): 59/16 Exclusion criteria: pathological lead points, late neglected intestinal obstruction, bowel perforation or shock
Interventions	Treatment group IM dexamethasone sodium sulphate: 0.5 mg/kg/8 h, immediately before the start of enema reduction and every 8 hours thereafter, for a total of 3 doses, plus nasogastric tube, IV fluids, antibiotics, and ultrasound‐guided saline enema reduction Control group Nasogastric tube, IV fluids, antibiotics, and ultrasound‐guided saline enema reduction alone
Outcomes	Complete reduction by ultrasound‐guided saline enema Incidence of recurrence during first 24 hours in hospital and during first week (early recurrence) and 6 months post reduction (late recurrence)
Notes	Procedure details: The technique of ultrasound‐guided saline enema reduction involved the following: "a reservoir filled with warm, normal saline was placed at a maximum height of 120cm above the table, with its upper end opened connected to a 10‐18‐Fr Foley's catheter." The enema could be repeated twice more, after a 30‐minute rest, if the initial attempt failed (i.e. lack of reduction within 5 minutes) The ratio of participants requiring non‐surgical reduction to those requiring surgical reduction was 60:15. In other words, 4/5 participants had successful reduction achieved with non‐surgical techniques
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	“The cases were randomly classified into two groups…”. No further details supplied
Allocation concealment (selection bias)	Unclear risk	“The cases were randomly classified into two groups…”. No further details supplied
Incomplete outcome data (attrition bias) All outcomes	Low risk	All 75 cases were reported, including those that failed initial intervention: "Cases who failed ultrasound guided saline enema reduction underwent surgical exploration, with operative details and postoperative complications also reported"
Selective reporting (reporting bias)	Low risk	Study includes all expected outcomes
Blinding of participants and personnel (performance bias) All outcomes	High risk	No placebo treatment used in control group
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not specified who assessed outcomes