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Intussusception. Part 1: a review of diagnostic approaches
1Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada. alan.daneman@sickkids.ca
Insights
Diagnosing childhood intussusception, a serious bowel condition, can be challenging. Imaging like ultrasound and X-rays are crucial for prompt and accurate diagnosis to prevent severe complications.
Area of Science:
- Pediatric Radiology
- Gastroenterology
- Abdominal Imaging
Background:
- Symptomatic intussusception in children most commonly occurs in the ileum.
- Clinical diagnosis of idiopathic intussusception can be challenging.
- Delayed diagnosis may lead to severe complications including bowel ischemia, perforation, and shock.
Purpose of the Study:
- To review current concepts and controversial issues in the imaging diagnosis of intussusception.
- To emphasize the importance of prompt and accurate diagnosis through imaging.
Main Methods:
- Review of current literature on intussusception diagnosis.
- Discussion of imaging modalities including sonography, plain abdominal radiographs, and contrast/air enema.
Main Results:
- Intussusception diagnosis often relies on imaging due to clinical diagnostic difficulties.
- Sonography, plain abdominal radiographs, and contrast/air enema are key imaging tools.
Conclusions:
- Accurate and timely imaging is essential for diagnosing intussusception in children.
- Understanding imaging techniques and controversies aids in effective patient management.
Abstract:
The vast majority of symptomatic intussusceptions in children arise in the ileum and are either ileocolic or ileoileocolic. The clinical diagnosis of these "idiopathic" intussusceptions may be difficult to make. Failure to make a prompt diagnosis and initiate appropriate treatment may lead to bowel ischemia, perforation, peritonitis, shock and even death. The clinician, therefore, may have to rely on imaging procedures to diagnose or exclude the presence of intussusception promptly and accurately. The imaging diagnosis of intussusception can be made with sonography or plain abdominal radiographs or by contrast (including air) enema examinations of the colon. This article highlights the current concepts and some controversial issues related to the imaging diagnosis of intussusception.