The major portion of the reduction is done intra-abdominally by milking the mass back along the descending colon, trans-verse colon, and ascending colon. When reduction has proceeded thus far, the remainder can be delivered out of the abdominal cavity. The mass is pushed back along the descending colon by squeezing the colon distal to the intussusception (Figure 7). If traction is applied, it should be extremely gentle to avoid rupturing the bowel. The discolored and edematous bowel at first may not appear to be viable, but the application of warm saline solution may improve its tone and appearance. Unless the intestine is necrotic, it is better to persist in attempts at reduction than to resort to early and unnecessary resection, required in less than 5 percent of the cases. An etiologic factor, such as an inverted Meckel's diverticulum or intestinal polyp, is found in only 3 or 4 percent of childhood cases of intussusception. It is unnecessary to tack down the terminal ileum or to anchor the mesentery. Recurrences are not common, and such preventive procedures only prolong the operation. Intussusception is uncommon in adults. It may occur at any level of the small or large intestine. After the intussusception in adults has been reduced, a search should be made for the initiating cause—i.e., tumors (especially intrinsic), adhesive bands, Meckel's diverticulum, and so forth. Resection is indicated if dead bowel is encountered.