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Pediatric small bowel intussusception disease: feasibility of screening for surgery with early computed tomographic

Sheung-Fat Ko1, Mao-Meng Tiao, Chie-Song Hsieh

  • 1Department of Radiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan. sfatko@adm.cgmh.org.tw

Surgery
|December 17, 2009
PubMed

Insights

Early computed tomographic (CT) evaluation for pediatric small bowel intussusception disease (SBID) significantly reduces surgical waiting times and bowel complications. This approach is effective in managing SBID cases that mimic other conditions.

Area of Science:

  • Pediatric Surgery
  • Diagnostic Imaging
  • Gastroenterology

Background:

  • Small bowel intussusception disease (SBID) in children can present with non-specific symptoms, mimicking ileocolic intussusception.
  • Delayed diagnosis and treatment of SBID can lead to significant morbidity, including bowel ischemia and complications.

Purpose of the Study:

  • To evaluate the feasibility and effectiveness of early computed tomographic (CT) scans in diagnosing pediatric SBID.
  • To compare operative outcomes between a conventional management group and a group utilizing early CT evaluation.

Main Methods:

  • Retrospective comparison of 18 patients with surgically proven SBID (1988-1999) managed conventionally versus 15 patients (2000-2008) with early CT evaluation for suspicious ultrasound findings.
  • Analysis of clinical, imaging, and operative data, including time to surgery and complication rates.

Main Results:

  • Early CT group patients experienced a significantly shorter duration from admission to surgery (7.47 vs 31.44 hours) compared to the conventional group.
  • The rate of bowel complications was significantly lower in the early CT group (6.7% vs 44.4%).
  • No significant differences were observed in patient demographics, clinical presentations, or imaging features between the groups.

Conclusions:

  • Early CT evaluation is effective for pediatric SBID, especially when ultrasound findings are atypical or suspicious.
  • Implementing early CT scans can prevent unnecessary reduction enemas and reduce delays in surgical intervention.
  • This strategy significantly lowers the incidence of bowel complications associated with SBID.
Abstract

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