CT of intussusception in the pediatric patient: diagnosis and pitfalls

Cox, Tyler; Winters, William D.; Weinberger, Edward

doi:10.1007/bf01403699

Cited by 32 publications

(15 citation statements)

References 11 publications

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“…Nowadays contrast enema is not recommended as the primary method to detect intussusception [24]. Computed tomography (CT) and magnetic resonance imaging (MRI) are able to diagnose intussusception with high accuracy [25][26][27][28].…”

Section: Diagnostic Imagingmentioning

confidence: 99%

Current radiological management of intussusception in children

et al. 2007

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Intussusception is the most common abdominal emergency situation in infants and small children. There has been great progress in diagnostic and therapeutic management of intussusception. Ultrasound (US) has been shown to be the first-choice imaging technique in diagnosing intussusception for reasons of high accuracy, simultaneous exclusion of differential diagnoses, and disclosure of additional pathologies. Controversial opinions exist worldwide concerning the nonoperative treatment of intussusception in infants and children. Pneumatic reduction under fluoroscopic guidance and hydrostatic reduction under US monitoring are the preferred techniques. The aim should be a success rate of at least 90% in idiopathic intussusception. This review summarizes different types of intussusception and outlines diagnostic aspects as well as several treatment concepts.

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Section: Diagnostic Imagingmentioning

confidence: 99%

Current radiological management of intussusception in children

et al. 2007

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“…The condition is likely to be fatal if not corrected. The diagnosis can be confirmed by ultrasonography supplemented with colour Doppler imaging [3,4] or radiographically-with the help of air insufflation or barium enema [5]; CT is also a very useful method [6,7]. Early hospitalization and appropriate (conservative or surgical) treatment usually provide favourable outcomes.…”

Section: Introductionmentioning

confidence: 99%

Intussusception in children: 11-year experience in Vladivostok

et al. 2006

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Idiopathic intussusception is an important abdominal emergency in infancy and childhood. The nonoperative management by air enema has always been the standard of care in Russia. Our purpose is to assess our reduction rate and the rate of complications. We performed a retrospective analysis of all intussusception cases seen at the Department of Paediatric Surgery from 1994 to 2005. The data obtained included age, sex, clinical presentation, diagnostic procedures, mode of treatment, and results. Patients included 280 children from 1 month to 14 years of age. Eighty-one percent of children were under age 1 year old, 61% were boys. The duration of symptoms before treatment was less than 18 h in 65%, 18-24 h in 21%, and more than 24 h in 14% of patients. The successful reduction rate was 86.1%. One patient with a duration of symptoms more than 24 h experienced colon perforation. Thirty-nine patients underwent surgery and, among these, abnormalities in the intestinal wall required resection in 12 cases. An association between the duration of symptoms and the outcome of the non-surgical treatment was present; non-surgical reduction was successful in 97.3% in the group with the duration of symptoms less than 18 h, 86.4% in 12-24 h, and 33.3% in more than 24 h. Air enema is a safe and effective approach for uncomplicated intussusception reduction with a high success rate, but the duration of symptoms directly increases the complication rate.

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“…It could be inferred that the lack of normal rotation and fixation of the duodenum may act as a predisposing factor of intussusception. In addition, one patient was diagnosed with familial adenomatous polyposis [20] and eight with PJS [15,19,21,32,35,39,40].…”

Section: Discussionmentioning

confidence: 99%

“…It tends to occur more frequently in adult and female patients. There were 39 adults and nine children [36][37][38][39][40][41][42][43][44]. The age of presentation ranged from 10 months to 73 years, with a median of 38.0 years.…”

Section: Discussionmentioning

confidence: 99%

Duodenal intussusception due to a giant neuroendocrine carcinoma in a patient with Peutz–Jeghers syndrome

Chen

Yu²,

Yang³

et al. 2012

European Journal of Gastroenterology & Hepatology

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Duodenal intussusception is a rare entity. To date, only a few cases have been reported in the literature. In this report, a case of duodenal intussusception due to an unusual tumor was presented and the clinical features of this entity were discussed. A 42-year-old man with Peutz-Jeghers syndrome presented with epigastric pain, vomiting, and severe anemia. Computed tomography scan revealed synchronous duodenojejunal and jejunojejunal intussusceptions. An emergency laparotomy revealed a polypoid mass originating from the lateral wall of the descending duodenum with intussusception of the distal duodenum. Histological examination demonstrated a poorly differentiated neuroendocrine carcinoma with muscularis infiltration, vascular invasion, and a Ki-67 index of 20%. A comprehensive literature search revealed 44 English reports that provided adequate descriptions of an additional 47 such cases. Clinical presentation was usually chronic and nonspecific. Diagnostic modalities included ultrasonography, upper gastrointestinal series, computed tomography, and endoscopy. Five patients were due to a non-neoplastic lesion; however, the other 43 patients were secondary to a tumor, benign in 35 cases and malignant in eight cases. Only one patient was treated by endoscopic polypectomy, whereas the remaining underwent open surgeries. Duodenal intussusception is a challenging condition due to its rarity and nonspecific presentation. It should be considered in the differential diagnosis of gastric outlet obstruction, upper gastrointestinal bleeding, pancreatitis, and obstructive jaundice.

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CT of intussusception in the pediatric patient: diagnosis and pitfalls

Cited by 32 publications

References 11 publications

Current radiological management of intussusception in children

Current radiological management of intussusception in children

Intussusception in children: 11-year experience in Vladivostok

Duodenal intussusception due to a giant neuroendocrine carcinoma in a patient with Peutz–Jeghers syndrome

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