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Ultrasonographic findings of small bowel intussusception, focusing on differentiation from ileocolic intussusception

N H Park1, S I Park, C S Park

  • 1Department of Diagnostic Radiology, Myongji Hospital, Kwandong University, College of Medicine, 697-24 Hwajung-dong, Dukyang-ku, Koyang, Kyunggi 412-270, Republic of Korea. nhpark904@kwandong.ac.kr

The British Journal of Radiology
|September 19, 2007
PubMed

Insights

Transient small bowel intussusception (SBI) in children typically presents in the right lower quadrant or periumbilical area. Differentiating SBI from ileocolic intussusception (ICI) on ultrasound is crucial for diagnosis.

Area of Science:

  • Pediatric Radiology
  • Gastrointestinal Imaging
  • Abdominal Ultrasound

Background:

  • Intussusception is a common surgical emergency in children.
  • Differentiating transient small bowel intussusception (SBI) from ileocolic intussusception (ICI) is essential for appropriate management.
  • Ultrasonography is the primary imaging modality for diagnosing intussusception in pediatric patients.

Purpose of the Study:

  • To characterize the typical ultrasonographic findings of transient small bowel intussusception (SBI) in children.
  • To establish sonographic criteria to differentiate transient SBI from ileocolic intussusception (ICI) in pediatric patients.

Main Methods:

  • Retrospective evaluation of 22 cases of transient SBI and 27 cases of ICI diagnosed via ultrasonography.
  • Comparison of ultrasonographic features including location, anteroposterior (AP) diameter, outer rim thickness, and presence of mesenteric lymph nodes within the intussuscipiens.
  • Analysis of patient demographics (age, sex) for both groups.

Main Results:

  • Transient SBI predominantly occurred in the right lower quadrant (RLQ) or periumbilical region, with a smaller mean AP diameter (1.38 cm) and thinner outer rim (0.26 cm) compared to ICI.
  • Ileocolic intussusception (ICI) was more commonly located in the right upper quadrant (RUQ) or epigastrium, exhibiting a larger mean AP diameter (2.53 cm) and thicker outer rim (0.53 cm).
  • Mesenteric lymph nodes were identified within the intussuscipiens in 96.3% of ICI cases, but not in any transient SBI cases.

Conclusions:

  • Transient SBI in pediatric patients can be distinguished from ICI based on specific ultrasonographic findings.
  • Key differentiating features include location (RLQ/periumbilical for SBI vs. RUQ/epigastric for ICI), smaller diameter, thinner rim, and absence of mesenteric lymph nodes in transient SBI.
  • Accurate sonographic differentiation aids in timely diagnosis and management of pediatric intussusception.

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