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Intussusception and the diagnostic value of testing stool for occult blood
1Department of Pediatrics, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee 53201.
Insights
Testing for occult blood in stool can help diagnose intussusception in children. A positive test significantly indicates intussusception, especially when other symptoms are unclear.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
- Clinical Pathology
Background:
- Intussusception is a common cause of bowel obstruction in children.
- Early diagnosis is crucial for effective treatment and reducing complications.
- Nonspecific signs and symptoms can make diagnosis challenging.
Purpose of the Study:
- To evaluate the diagnostic utility of testing for occult blood in stool for children suspected of intussusception.
- To determine the association between stool occult blood and confirmed intussusception.
- To compare the effectiveness of stool occult blood testing with other clinical factors.
Main Methods:
- Retrospective review of 96 children undergoing barium enema for suspected intussusception.
- Analysis of stool occult blood test results in patients with and without confirmed intussusception.
- Statistical comparison of clinical factors associated with intussusception.
Main Results:
- Stool occult blood testing was positive in 75% of children with intussusception who lacked gross rectal bleeding.
- Only 20% of children without intussusception had a positive stool occult blood test.
- Stool occult blood positivity was significantly associated with intussusception (P < .002).
- Abdominal mass was the only other significant clinical factor associated with intussusception (P < .02).
- Symptoms like vomiting, irritability, poor feeding, abdominal pain, and lethargy did not significantly differ between groups.
Conclusions:
- Stool testing for occult blood is a valuable diagnostic tool for intussusception in children presenting with nonspecific symptoms.
- Occult blood in stool should be considered when evaluating children with suspected intussusception.
- This test can aid in differentiating intussusception from other conditions when clinical signs are ambiguous.
Abstract:
A retrospective review was performed to determine the diagnostic value of testing for occult blood in stool of children suspect for intussusception. Ninety-six children had barium enema studies for suspected intussusception. Of the 57 children who had barium enema confirmed intussusception, 29 did not have history or physical findings of gross blood per rectum. Stool was tested for occult blood in 16 of these 29 patients, and 12 (75%) were positive. In comparison, three (20%) of the children who did not have intussusception had stool positive for occult blood. Stool with occult blood was significantly associated with intussusception (P less than .002). The only other clinical factor significantly associated with intussusception was abdominal mass (P less than .02). Vomiting, episodic irritability, poor feeding, abdominal pain and lethargy were not significantly different in the two groups. In conclusion, the authors suggest stool testing for occult blood when evaluating children who present with nonspecific signs and symptoms supportive of intussusception.