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[Intestinal intussusception in children. Ultrasonic diagnosis]
Z Smoljanić1, G Zivić, Z Krstić
1Univesity Children's Department, Belgrade. smoljzel@EUnet.yu
Insights
Ultrasound effectively diagnoses childhood intestinal intussusception, reducing X-ray exposure. It also aids in guiding hydrostatic reduction, proving reliable for this common pediatric condition.
Area of Science:
- Pediatric Radiology
- Diagnostic Imaging
Background:
- Intestinal intussusception is a common surgical emergency in children.
- Conventional diagnostic methods like irrigography carry risks of radiation exposure.
Purpose of the Study:
- To evaluate the efficacy of ultrasound in diagnosing intestinal intussusception in pediatric patients.
- To assess ultrasound's role in guiding therapeutic interventions for intussusception.
Main Methods:
- Retrospective analysis of 35 children with suspected intussusception.
- Ultrasound examination for diagnosis and real-time monitoring during hydrostatic reduction.
- Surgical confirmation for intraluminal lesions.
Main Results:
- Ultrasound accurately diagnosed intussusception in 74% of cases (26/35) with no false positives or negatives.
- Identified underlying causes in secondary intussusception, including Meckel's diverticula.
- Successful hydrostatic reduction under ultrasound guidance in 68% of idiopathic cases (15/22).
Conclusions:
- Ultrasound is a reliable and safe diagnostic tool for pediatric intestinal intussusception.
- Ultrasound is valuable for monitoring hydrostatic reduction and identifying secondary causes.
- Combined ultrasound and fluoroscopy are recommended for suspected perforation.
Abstract:
The aim of the paper is to demonstrate a successful use of ultrasound in the diagnosis of intestinal intussusception in children. Ultrasound decreases the number of irrigographic examinations and reduces diagnostic exposure of children to X-rays. In the last three years 35 children, aged from 3 months to 15 years (average 2 years), had a suspected clinical diagnosis of intussusception. The ultrasound studies revealed intestinal intussusception in 26 patients (74%). There were no false positive or false negative ultrasound findings. In four patients with secondary intussusception the main symptoms were identified (three solid lesions and two Meckel's diverticula). Intraluminal lesions at the apex of intussusception were confirmed by surgery. In 22 patients intussusception was idiopathic. In 15 of these patients (68%), hydrostatic desinvaginations, under combined ultrasound and radioscopic control, were successful. High grade unsuccessful hydrostatic reductions were associated with long persistence of symptoms (2 to 9 days). Ultrasound is reliable in diagnosis of intestinal intussusception and useful in control of hydrostatic reduction. In patients with expected intestinal perforation ultrasound should be combined with fluoroscopy.