Clinical application of ultrasonography in the diagnosis of intussusception

Bhisitkul, Donna M.; Listernick, Robert; Shkolnik, Arnold; Donaldson, James S.; Henricks, Bret D.; Feinstein, Kate A.; Fernbach, Sandra K.

doi:10.1016/s0022-3476(05)81185-0

Cited by 91 publications

(42 citation statements)

References 6 publications

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“…Ultrasound was found to be a reliable diagnostic screening modality in suspected cases of intussusception and ultrasound guidance is a promising technique for therapeutic reduction of intussusception. 2,13 . Thirty-two of our patients (53%) had surgical intervention with simple reduction in 22 patients (68.8%) and resection and anastomosis in 10 patients (31.2%).…”

Section: Discussionmentioning

confidence: 99%

Intussusception in Infants and Children: A Review of 60 Cases

Albassam

Orfale

1995

Annals of Saudi Medicine

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Sixty pediatric patients with intussusception seen at Maternity and Children's Hospital over 2.5 years were retrospectively reviewed. There were 33 males and 27 females ranging in age from 1.5 months to 108 months with a mean of 11.5 months. Seventeen patients (28.3%) presented more than 48 hours after their symptoms started. Vomiting was the most common symptom (93.3%) followed by rectal bleeding (71.6%) and abdominal pain (48.3%). The clinical signs included the presence of blood per rectal examination in 58.3% of patients and palpable mass in 46.6% of patients. Most intussusceptions were of ileocolic type (88%). Hydrostatic barium enema reduction was tried in 50 patients (83.3%) with an overall success rate of 56%. Fify-three percent of patients had surgical treatment for their intussusception. Ten patients (16.6%) required bowel resection. The leading point was identified in 10% of patients. Meckel's diverticulum was the most common finding. The average hospital stay was two to five days after barium reduction and seven days after surgical treatment. There were no deaths. One patient had perforation of the bowel during hydrostatic reduction and another had chest infection postoperatively. There were no recurrences in our series. In conclusion, it appears that failure to diagnose intussusception in the first 24 hours will decrease the successful rate of hydrostatic reduction and increase the need for surgical intervention and the period of hospitalization. Barium enema reduction is the treatment of choice in all cases unless contraindicated. Intussusception is one of the most common causes of intestinal obstruction in the first two years of life. In the majority of cases there is no underlying cause. The classical presentation of abdominal colic, abdominal mass, and passage of red currant jelly stool occur in only one-third of cases.1 Although barium enema is the standard method for the diagnosis and treatment, a new method of using air enema and ultrasound-guided hydrostatic reduction have been introduced with successful results. [2][3][4] This paper studies the clinical presentation and management of intussusception as seen at Maternity and Children's Hospital in Riyadh over a period of 2.5 years in infants and children. Material and MethodsThe medical records of 60 consecutive infants and children treated for intussusception at Maternity and Children's Hospital, Riyadh, over 2.5 years were studied. The diagnosis was confirmed radiologically and/or at surgery. The records of these patients were reviewed with respect to age, sex, nationality, hospital stay, month of admission, clinical presentation, investigation, mode of treatment, morbidity and mortality, underlying cause and incidence of recurrence.Barium enema for diagnostic and therapeutic purposes was performed in most of the patients. In our hospital, barium enema reduction was performed by introducing barium contrast through a Foley catheter placed into the rectum and secured by inflation of the catheter balloon and strapping of the buttocks. A colum...

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Section: Discussionmentioning

confidence: 99%

Intussusception in Infants and Children: A Review of 60 Cases

Albassam

Orfale

1995

Annals of Saudi Medicine

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“…17 The first-line investigation for diagnosis of intussusception in children is abdominal ultrasound, given its high sensitivity (98%-100%) and specificity (88%-100%). 18 Non-operative reduction methods for intussusception include barium enema, and hydrostatic or pneumatic reduction. 19 Pneumatic reduction is currently the preferred standard treatment, given the greater ease of performing the examination, the lesser morbidity with complications, and the slightly higher success rate of 84% to 100%.…”

Section: Implications For Clinical Practice or Policymentioning

confidence: 99%

Childhood intussusception: 17-year experience at a tertiary referral centre in Hong Kong

et al. 2015

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Objectives:To review all paediatric patients with intussusception over the last 17 years. Design: Retrospective case series.Setting: A tertiary centre in Hong Kong. Patients:Children who presented with intussusception from January 1997 to December 2014 were reviewed. Main outcome measures:The duration of symptoms, successful treatment modalities, complication rate, and length of hospital stay were studied.Results: A total of 173 children (108 male, 65 female) presented to our hospital with intussusception during the study period. Their median age at presentation was 12.5 months (range, 2 months to 16 years) and the mean duration of symptoms was 2.3 (standard deviation, 1.8) days. Vomiting was the most common symptom (76.3%) followed by abdominal pain (46.2%), per rectal bleeding or red currant jelly stool (40.5%), and a palpable abdominal mass (39.3%). Overall, 160 patients proceeded to pneumatic or hydrostatic reduction, among whom 127 (79.4%) were successful. Three (1.9%) patients had bowel perforation during the procedure. Early recurrence of intussusception occurred in four (3.1%) patients with non-operative reduction. No

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“…20. The choice of this ␣ level for entry allows for consideration of variables that show a trend toward significance in the univariate analysis, and may achieve significance in the presence of other variables.…”

Section: Multivariate Analysismentioning

confidence: 99%

Predictors of Intussusception in Young Children

Kuppermann¹,

O'Dea²,

Pinckney³

et al. 2000

Arch Pediatr Adolesc Med

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Objective: To identify predictors of intussusception in young children.Design: A retrospective cross-sectional study. Setting and Patients:A consecutive sample of children younger than 5 years on whom contrast enemas were performed because of suspected intussusception seen at an urban children's hospital from 1990 to 1995. Methods:We evaluated historical, clinical, and radiographic variables. Variables documented in 75% or more of the medical records and associated with intussusception (PՅ.20) in the univariate analysis were evaluated in a multiple logistic regression analysis. Variables retaining significance (PՅ.05) in the multivariate analysis were considered independent predictors of intussusception. We used bootstrap resampling techniques to validate the multivariate model.Results: Sixty-eight (59%) of the 115 patients had intussusception. Univariate predictors of intussusception included male sex, age younger than 2 years, history of emesis, rectal bleeding, lethargy, abdominal mass, and a highly suggestive abdominal radiograph. In the multivariate analysis, we identified only 4 independent predictors (adjusted odds ratio; 95% confidence interval): a highly suggestive abdominal radiograph (18.3; 4.0-83.1), rectal bleeding (17.3; 2.9-104.0), male sex (6.2; 1.2-32.3), and a history of emesis (13.4; 1.4-126.0). We identified 3 of these 4 variables (all but emesis) as independent predictors in more than 50% of 1000 bootstrap data samples.Conclusions: Rectal bleeding, a highly suggestive abdominal radiograph, and male sex are variables independently associated with intussusception in a cohort of children suspected of having this diagnosis. Knowledge of these variables may assist in clinical decision making regarding diagnostic and therapeutic interventions.Arch Pediatr Adolesc Med. 2000;154:250-255

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Clinical application of ultrasonography in the diagnosis of intussusception

Cited by 91 publications

References 6 publications

Intussusception in Infants and Children: A Review of 60 Cases

Intussusception in Infants and Children: A Review of 60 Cases

Childhood intussusception: 17-year experience at a tertiary referral centre in Hong Kong

Predictors of Intussusception in Young Children

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