Reliability of color Doppler and power Doppler sonography in the evaluation of intussuscepted bowel viability

Hanquinet, Sylvianne; Anooshiravani, Mehrak; Vunda, Aaron; Coultre, C. Le; Bugmann, Philippe

doi:10.1007/s003830050339

Cited by 40 publications

(23 citation statements)

References 3 publications

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“…16 By contrast, in the present study, all the patients were symptomatic and lead points (hamartomatous polyps for four patients and Meckel's diverticula for two) were noted for 44% of cases of pediatric SBI. Despite sonographic identification of various lead points such as enterogenous cyst, lipoma, lymphangioma, Meckel's diverticulum, and Peutz-Jeghers syndrome having been described for SBI, [29][30][31][32][33] none of the underlying lesions could have been definitively diagnosed by sonography, and we found the preoperative recognition of the lead points of SBI difficult.…”

Section: Discussionmentioning

confidence: 76%

Sonographic Features of Small‐bowel Intussusception in Pediatric Patients

Tiao

Wan

et al. 2001

Academic Emergency Medicine

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Objective: Small-bowel intussusception (SBI) for pediatric patients is unusual and difficult to diagnose preoperatively. This study sought to determine the sonographic findings of pediatric SBI. Methods: The sonographic features and surgical findings of 13 pediatric patients (7 boys, 6 girls; age range 4 months-15 years; average age 4 years and 2 months) with SBI encountered in the authors' hospital over a 12-year period were retrospectively reviewed. Results: Most of the patients presented with nonspecific symptoms , including vomiting, abdominal pain, and/or irritable crying. Sonographic screening in the emergency department revealed a doughnut or crescent-in-doughnut sign, or a multiple-concentric-rings sign for 11 of the 13 patients, and the lesions appeared short. Eight lesions were found in the paraumbilical or left abdominal regions. Sonographic measurement of the size of the lesions from these 11 patients ranged from 2 cm to 3.7 cm (average 2.77 cm). Subsequent barium enemas were performed for these 11 patients, none of which revealed colon lesions. Surgery revealed ileoileal intussusceptions for eight cases, jejunoileal for three, and jejunojejunal for the remaining two. Bowel ischemia or necrosis and pathologic lead points were demonstrated for seven and six patients, respectively, although none were recognized preoperatively. Conclusions: Small-bowel intussusception is often overlooked due to nonspecific clinical presentations. Sono-graphic demonstration of a 2-3-cm sized, short, doughnut-like lesion, especially in the left abdomen or paraumbilical regions, should lead to strong suspicion of SBI.

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Section: Discussionmentioning

confidence: 76%

Sonographic Features of Small‐bowel Intussusception in Pediatric Patients

Tiao

Wan

et al. 2001

Academic Emergency Medicine

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“…Although the CDI was employed for prediction of the reducibility and viability of the bowel (14-16), the vascular flow did not always exclude a necrotic bowel (17). The flow signal appeared in both benign and surgical SBIs including those with necrotic bowel (7, 8), and CDI does not seem to be effective for the prediction of spontaneous reducibility of the SBI.…”

Section: Discussionmentioning

confidence: 99%

US Features of Transient Small Bowel Intussusception in Pediatric Patients

Kim

2004

Korean J Radiol

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ObjectiveTo describe the sonographic (US) and clinical features of spontaneously reduced small bowel intussusception, and to discuss the management options for small bowel intussusception based on US findings with clinical correlation.Materials and MethodsDuring a five years of period, 34 small bowel intussusceptions were diagnosed on US in 32 infants and children. The clinical presentations and imaging findings of the patients were reviewed.ResultsThe clinical presentations included abdominal pain or irritability (n = 25), vomiting (n = 5), diarrhea (n = 3), bloody stool (n = 1), and abdominal distension (n = 1), in combination or alone. US showed multi-layered round masses of small (mean, 1.5±0.3 cm) diameters and with thin (mean, 3.5±1 mm) outer rims along the course of the small bowel. The mean length was 1.8±0.5 cm and peristalsis was seen on the video records. There were no visible lead points. The vascular flow signal appeared on color Doppler images in all 21 patients examined. Spontaneous reduction was confirmed by combinations of US (n = 28), small bowel series (n = 6), CT scan (n = 3), and surgical exploration (n = 2). All patients discharged with improved condition.ConclusionTypical US findings of the transient small bowel intussusception included 1) small size without wall swelling, 2) short segment, 3) preserved wall motion, and 4) absence of the lead point. Conservative management with US monitoring rather than an immediate operation is recommended for those patient with typical transient small bowel intussusceptions. Atypical US findings or clinical deterioration of the patient with persistent intussusception warrant surgical exploration.

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“…Multiple hyperechogenic and hypoechogenic stratifications may be found. Colour Doppler can be used to evaluate the viability of the intussuscepted bowel [47].…”

Section: Intussusceptionmentioning

confidence: 99%

Transabdominal sonography of the gastrointestinal tract

et al. 2001

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Like other cross-sectional imaging methods, transabdominal sonography is increasingly used for evaluation of gastrointestinal diseases. The potentials and limitations of sonography in evaluation of the gastrointestinal tract are discussed. Transabdominal sonography proved to be of clinical value in assessment of appendicitis, diverticulitis, bowel obstruction, chronic inflammatory bowel diseases, intussusception and infantile hypertrophic pyloric stenosis. The sonographic morphology of the most common gastrointestinal diseases is discussed. In experienced hands sonography can be used as primary imaging in several gastrointestinal diseases. The gastrointestinal tract should be included in the sonographic examination of the abdomen, especially if symptoms could be related to the intestine.

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Reliability of color Doppler and power Doppler sonography in the evaluation of intussuscepted bowel viability

Cited by 40 publications

References 3 publications

Sonographic Features of Small‐bowel Intussusception in Pediatric Patients

Sonographic Features of Small‐bowel Intussusception in Pediatric Patients

US Features of Transient Small Bowel Intussusception in Pediatric Patients

Transabdominal sonography of the gastrointestinal tract

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