Japanese Guidelines for the management of intussusception in children, 2011

Ito, Yasuo; Kusakawa, Isao; Murata, Yuji; Ukiyama, Etsuji; Kawase, Hirokazu; Kamagata, Shoichiro; Ueno, Shinji; Osamura, Toshio; Kubo, Minoru; Yoshida, Masahiro

doi:10.1111/j.1442-200x.2012.03622.x

Cited by 11 publications

(17 citation statements)

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“…Evidence-based guidelines for management of intussusception in Japan [7] propose severity assessment and patient transfer criteria to assist in stratifying the risks and to aid in selecting an appropriate subpopulation that may benefit from immediate reduction. These guidelines may help in efficient triage of intussusception cases in which immediate imaging-guided intussusception reduction without transfer would be most beneficial for the patient, provided that the time it takes for transfer is greater than the response time of the surgical team and that the rate of complications at the institution at which the patient presents is within the norm.…”

Section: Nguyen Et Almentioning

confidence: 99%

Intussusception Revisited: Is Immediate On-Site Surgeon Availability at the Time of Reduction Necessary?

Nguyen

Kan

Guillerman³

et al. 2014

American Journal of Roentgenology

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In this series, complications requiring immediate medical or surgical attention were rare, occurring in 1.6% of cases (five bowel perforations, two cases of hemodynamic instability without perforation). On-site surgeon presence may not be necessary at the time of radiologically guided reduction attempts provided that the attending physician is facile with percutaneous needle decompression and management of hemodynamic instability and that ultimate surgical care can be arranged expeditiously.

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Section: Nguyen Et Almentioning

confidence: 99%

Intussusception Revisited: Is Immediate On-Site Surgeon Availability at the Time of Reduction Necessary?

Nguyen

Kan

Guillerman³

et al. 2014

American Journal of Roentgenology

View full text Add to dashboard Cite

show abstract

“…Moreover, the intussusception group in this study presented a lower prevalence of vomiting (37.1%) and bloody stool (21.4%) than did those in previous studies, which reported vomiting in 85% and bloody stool in up to 65% of patients [17]. According to the clinical course of intussusception, as intestinal obstruction progresses, abdominal pain appears first, followed by vomiting and bloody stool [4,13]. Thus, our findings indicated that most patients with intussusception were in the early stage and had not yet developed vomiting.…”

Section: Discussionmentioning

confidence: 49%

“…The criteria for performing POCUS were set to broader standards to detect intussusception at an early stage wherein POCUS was performed in the presence of the following symptoms: any one of intermittent abdominal pain/irritability or bloody stool, otherwise at least two symptoms among nonspecific abdominal pain/irritability, abdominal mass/distension, vomiting, or lethargy. These criteria were modified more inclusively base on the diagnostic criteria (a proposal) in the Japanese guidelines for the management of intussusception in children given in 2011 [13]. Patients transferred from another hospital with a confirmed diagnosis of intussusception were excluded.…”

Section: Pocusmentioning

confidence: 99%

Point-of-Care Ultrasound May Be Useful for Detecting Pediatric Intussusception at an Early Stage

Lee

Kim

Choi

et al. 2020

Preprint

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Background: This study aimed to verify the usefulness of point-of-care ultrasound (POCUS) performed by pediatric emergency physicians for detecting intussusception at an early stage.Methods: This retrospective study included 1-month-to 6-year-old children with clinically suspected intussusception, who underwent POCUS in the pediatric emergency department between December 2016 and February 2018. The criteria for performing POCUS were set to broader standards: presenting any one of intermittent abdominal pain/irritability or bloody stool, or ≥2 symptoms among nonspecific abdominal pain/irritability, abdominal mass/distension, vomiting, or lethargy. POCUS results were interpreted and categorized as "negative" or "suspicious," and a radiologist performed confirmatory ultrasound in "suspicious" cases.Results: We analyzed 575 POCUS scans from 549 patients (mean age, 25.5 months). Among the 92 "suspicious" cases (16.0%), 70 (12.2%) were confirmed to have intussusception. POCUS showed 100% sensitivity, 95.6% specificity, and 97.8% accuracy. Patients with confirmed intussusception were mainly diagnosed in the early stages, with a mean symptom duration of 11.7 hours, and most patients (97.1%) were treated successfully via air enema reduction. Compared to the nonintussusception group, the intussusception group had more intermittent abdominal pain ( P < 0.001), but less vomiting ( P = 0.001); the other clinical features showed no intergroup differences.Conclusion: POCUS performed using the criteria set to broader standards by pediatric emergency physicians may be useful for detecting intussusception at an early stage, which may present with obscure clinical symptoms. POCUS:Point-of-care ultrasound RADUS: Radiologist-performed ultrasound Declarations Ethics approval and consent to participate: The institutional review board of Asan Medical Center approved this study and waived the requirement for informed consent (study number 2018-0418).

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“…Moreover, the intussusception group in this study presented a lower prevalence of vomiting (37.1%) and bloody stool (21.4%) than did those in previous studies, which reported vomiting in 85% and bloody stool in up to 65% of patients [15]. According to the clinical course of intussusception, as intestinal obstruction progresses, abdominal pain appears first, followed by vomiting and bloody stool [3,11]. Thus, our findings indicated that most patients with intussusception were in the early stage and had not yet developed vomiting.…”

Section: Discussionmentioning

confidence: 49%

“…The criteria for performing POCUS were set to lower standards to detect intussusception at an early stage wherein POCUS was performed in the presence of any one of the following symptoms: intermittent abdominal pain/irritability, bloody stool, two or more causes of nonspecific abdominal pain/irritability, abdominal mass/distension, vomiting, or lethargy. The criteria were modified from the diagnostic criteria (a proposal) in the Japanese guidelines for the management of intussusception in children given in 2011 [11]. Patients transferred from another hospital with a confirmed diagnosis of intussusception were excluded.…”

Section: Pocusmentioning

confidence: 99%

Point-of-Care Ultrasound May Be Useful for Detecting Pediatric Intussusception at an Early Stage

Lee

Kim

Choi

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: This study aimed to verify the usefulness of point-of-care ultrasound (POCUS) performed by pediatric emergency physicians for detecting intussusception at an early stage. Methods: This retrospective study included 1-month-to 6-year-old children who underwent POCUS for the detection of intussusception in the pediatric emergency department between December 2016 and February 2018. The criteria for performing POCUS were set to lower standards wherein POCUS was performed in the presence of any one of the following symptoms: intermittent abdominal pain, bloody stool, ≥2 causes of nonspecific abdominal pain, abdominal mass, vomiting, or lethargy. POCUS results were interpreted and categorized as "negative" or "suspicious," and a radiologist performed confirmatory ultrasound in "suspicious" cases. Results: We analyzed 575 POCUS scans from 549 patients (mean age, 25.5 months). Among the 92 "suspicious" cases (16.0%), 70 (12.2%) were confirmed to have intussusception. POCUS showed 100% sensitivity, 95.6% specificity, and 97.8% accuracy. Patients with confirmed intussusception were mainly diagnosed in the early stages, with a mean symptom duration of 11.7 hours, and most patients (97.1%) were treated successfully via air enema reduction.Compared to the non-intussusception group, the intussusception group had more intermittent abdominal pain (P < 0.001), but less vomiting (P = 0.001); the other clinical features showed no intergroup differences. Conclusion: POCUS performed using the criteria set to lower standards by pediatric emergency physicians may be useful for detecting intussusception at an early stage, which may present with obscure clinical symptoms.

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Japanese Guidelines for the management of intussusception in children, 2011

Cited by 11 publications

References 0 publications

Intussusception Revisited: Is Immediate On-Site Surgeon Availability at the Time of Reduction Necessary?

Intussusception Revisited: Is Immediate On-Site Surgeon Availability at the Time of Reduction Necessary?

Point-of-Care Ultrasound May Be Useful for Detecting Pediatric Intussusception at an Early Stage

Point-of-Care Ultrasound May Be Useful for Detecting Pediatric Intussusception at an Early Stage

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