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Published on: March 5, 2018
Clinical and Ultrasonographic Features of Secondary Intussusception in Children
Yao Zhang1, Qian Dong2, Shi-Xing Li1
1Department of Ultrasound, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, People's Republic of China.
Insights
Ultrasound effectively differentiates secondary intussusception (SI) from primary intussusception (PI) in children. Identifying the pathological lead point (PLP) via ultrasound is crucial for diagnosing SI and its causes.
Area of Science:
- Pediatric Radiology
- Gastrointestinal Imaging
Background:
- Intussusception is a common surgical emergency in children.
- Distinguishing between primary intussusception (PI) and secondary intussusception (SI) is critical for appropriate management.
- Secondary intussusception is often associated with a pathological lead point (PLP).
Purpose of the Study:
- To review the ultrasonographic features of secondary intussusception (SI) in children.
- To assess the diagnostic value of ultrasound in pediatric SI.
- To compare clinical and ultrasonographic features of SI versus PI.
Main Methods:
- Retrospective analysis of ultrasound findings in 1977 PI cases and 37 SI cases.
- Comparison of clinical and ultrasonographic features between PI and SI groups.
- Confirmation of SI diagnoses via laparotomy or histopathology.
Main Results:
- Age, intussusception characteristics (location, diameter, length), lack of flatus/defecation, free intraperitoneal fluid, and proximal intestinal dilation differentiated PI from SI (P < 0.05).
- Ultrasound identified the PLP in all 37 SI cases.
- Common causes of SI identified included polyps, duplication cysts, lymphoma, and Meckel's diverticulum (56.8% of cases).
Conclusions:
- Ultrasound is a feasible and effective tool for discriminating between PI and SI in children.
- Detection of the PLP by ultrasound enables a definitive diagnosis of SI.
- Ultrasound aids in identifying the underlying cause of secondary intussusception.
Objectives:
The aim of this study was to review the ultrasonographic features of secondary intussusception (SI) in children and assess the value of ultrasound in the diagnosis of pediatric SI.
Methods:
The authors performed a retrospective analysis on the ultrasound findings of 1977 cases of primary intussusception (PI) and 37 cases of SI in children. The SI cases were diagnosed by ultrasonography and confirmed by laparotomy or histopathologic diagnosis. The clinical and ultrasonographic features were analyzed and compared between these two groups.
Results:
The age, no flatus or defecation, position, diameter and length of intussusception, the presence of free intraperitoneal liquid, and intestinal dialation at the proximal end present, all contributed to the differentiation between PI and SI (all P < 0.05). Ultrasound was able to demonstrate the pathological lead point (PLP) shadows in all of the 37 SI cases, either in the cervical part or intussusceptum of the intussusception. Among the 37 SI patients, 21 cases (56.8 %) were accurately categorized with lesions, including intestinal polyps, cystic intestinal duplication, intestinal wall lymphoma, and a small part of Meckel's diverticulum.
Conclusions:
Ultrasound can be used as a feasible and effective method to discriminate PI from SI. Once the PLP is detected, a definite diagnosis can be made.
Key Points:
• The clinical and ultrasonographic features were compared between SI and PI. • The age, location, diameter and length of intussusception, and intestinal dilation were distinguishing features. • The causes of SI were found to be polyps, intestinal duplication, lymphoma, and Meckel's diverticulum. • Ultrasound can be used as an important method to diagnose SI. • Demonstration and confirmation of PLP are vital to diagnosing SI.
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