Evolving Concepts in Ultrasonography of Pediatric Intussusceptions: Unequivocal Differentiation of Ileocolic, Obstructive and Transient Small-Bowel Intussusceptions

Goel, Ishan; Anand, Rama; Choudhury, Subhasis Roy; Agarwal, Shilpi

doi:10.1016/j.ultrasmedbio.2019.12.011

Cited by 6 publications

(8 citation statements)

References 16 publications

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“…This fact affirms the finding from our study that some TEIs cause acute abdominal pain. Additionally, in all those cases, the TEI involved a short bowel segment (less than 3 cm in length) and had small outer diameter (less than 2.5 cm), which is also in line with findings from our study [10].…”

Section: Discussionsupporting

confidence: 91%

“…This confirmed that these intussusceptions were correctly diagnosed as TEIs by the diagnostic criteria by Kim et al [6]. Other authors also report that US can reliably differentiate between ileocolic and enteroenteric intussusception [10,11]. In contrast, Bartocci et al [12] recently reported that it can be difficult to distinguish between an ileocolic intussusception and enteroenteric intussusception by US, and pointed out that the accuracy of the diagnosis very much depends on the experience of the examiner [12].…”

Section: Discussionmentioning

confidence: 53%

“…In 2020, Goel et al [10] published a study which included 90 children with clinical suspicion of intussusception. All included children had acute abdominal pain.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and significance of transient enteroenteric intussusceptions in children with recurrent colic abdominal pain

Plut

2020

Srp Arh Celok Lek

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Introduction/Objective. Recurrent colic abdominal pain (RCAP) is a common complaint in children. Children with this complaint are often referred to abdominal ultrasound (US). Examining the children with RCAP by US in our outpatient clinic we occasionally noticed transient enteroenteric intussusceptions (TEIs) with spontaneous resolution. The objectives of our prospective observational study were to determine the prevalence and evaluate the significance of TEIs in children with RCAP. Methods. From January 2016 to December 2017 we examined 358 children with RCAP by US. Age range was 1?17 years (mean age 7.7 years). TEIs were detected and the prevalence determined. The sensation of pain at the time of the US examination was noted. Results. We detected TEI in 41 children; the prevalence was 11.5%. Abdominal pain at the time of the presence of TEI was reported in 17.1% of these children. In the group of children without TEI detected, pain at the time of the examination was reported in only 6%. A statistically significant relationship was found between the presence of TEI and the pain at the time of the examination (p = 0.046). No child had other significant abdominal pathology. Conclusion. TEIs happen more commonly in children than previously thought. A rather high prevalence of TEIs in our study group of children with RCAP and the fact that higher percentage of children with detected TEI experienced pain at the time of the examination, are suggestive that TEIs may be one of the causes for the RCAP in children.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 53%

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Prevalence and significance of transient enteroenteric intussusceptions in children with recurrent colic abdominal pain

Plut

2020

Srp Arh Celok Lek

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“…The onion sign denotes the classical finding of bowel invagination, most often observed in children using ultrasound. [ 41 ] The characteristic pattern arises when the proximal part of a bowel segment is feeding into the bowel distally located, thus generating multiple layers resembling a section through an onion [ Figure 6 ]. If both the anterior and posterior walls are seen in a section through the bowel invagination, then 20 layers may be observed.…”

Section: E Xamination T Echniques and ...mentioning

confidence: 99%

Point-of-care Ultrasound of the Gastrointestinal Tract

Gilja

Nylund

2023

Journal of Medical Ultrasound

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The widespread use of portable ultrasound scanners has promoted the concept of point of care ultrasound (POCUS), namely “ultrasound performed bedside and interpreted directly by the clinician.” The purpose of this short review is to outline how POCUS can be used in patients with diseases of the gastrointestinal (GI) tract. POCUS is not a replacement for comprehensive ultrasound, but rather allows physicians immediate access to clinical imaging for rapid diagnosis and efficient work-up and treatment of the patients. There are many indications for doing POCUS of the GI tract, including abdominal pain, diarrhea, palpable masses, and to detect fluid or free air in the abdominal cavity. To improve the visibility of deeper parts of the abdomen, the graded compression technique with the scan head is useful. During POCUS, the operator should look for signs of severe pathology including target lesions, the pseudo-kidney sign, the onion sign, dilated bowel loops, gastric retention, free fluid, and free air, depending on the actual clinical problem. We conclude that POCUS of the GI tract is very useful to provide a rapid diagnosis in many clinical scenarios.

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“…Ileocolic intussusception is generally larger than ileoileal intussusception, with a mean diameter of 2.6 to 3.2 cm versus 1.4 to 2.1 cm, and the ratio of inner fat core diameter to outer wall thickness is greater than 1.0 in ileocolic intussusception and less than 1.0 in ileoileal intussusception. 4,5 Once a suspected…”

Section: Techniquementioning

confidence: 99%

A Surprising Lead Point in an Ileocolic Intussusception

2022

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Appendicitis and intussusception are 2 of the most common abdominal emergencies in children and have high rates of morbidity if not treated promptly. However, only rarely do they occur together. We present a case in which clinical suspicion for intussusception was not high. Point-of-care ultrasound (POCUS) was performed in the pediatric emergency department, revealing both ileocolic intussusception and appendicitis. This case reinforces the importance of maintaining a broad differential diagnosis in unclear clinical scenarios and of the potential utility of POCUS. In our case, identification of intussusception on POCUS facilitated expeditious treatment, identification of the lead point, and allowed the treating physicians to prepare for the possibility of surgical management.

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Evolving Concepts in Ultrasonography of Pediatric Intussusceptions: Unequivocal Differentiation of Ileocolic, Obstructive and Transient Small-Bowel Intussusceptions

Cited by 6 publications

References 16 publications

Prevalence and significance of transient enteroenteric intussusceptions in children with recurrent colic abdominal pain

Prevalence and significance of transient enteroenteric intussusceptions in children with recurrent colic abdominal pain

Point-of-care Ultrasound of the Gastrointestinal Tract

A Surprising Lead Point in an Ileocolic Intussusception

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