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Ileocolic intussusception: new sign on the supine cross-table lateral radiograph
1Tripler Army Medical Center, Honolulu, Hawaii.
Insights
Detecting ileocolic intussusception in infants using supine cross-table lateral abdominal radiographs is feasible. This imaging technique identified intussusceptions in nine of 12 cases, aiding in early diagnosis.
Area of Science:
- Pediatric Radiology
- Gastrointestinal Imaging
- Abdominal Diagnostics
Background:
- Ileocolic intussusception is a common surgical emergency in infants.
- Accurate and timely diagnosis is crucial for optimal patient outcomes.
- Radiographic interpretation plays a key role in diagnosing intussusception.
Purpose of the Study:
- To prospectively evaluate the diagnostic utility of supine cross-table lateral abdominal radiographs for detecting ileocolic intussusception in infants.
- To assess the specific radiographic signs indicative of intussusception on this view.
Main Methods:
- Prospective evaluation of 12 infant cases with suspected ileocolic intussusception over a 2-year period.
- Analysis of supine cross-table lateral abdominal radiographs for characteristic signs of intussusception.
- Correlation of radiographic findings with clinical diagnosis.
Main Results:
- Ileocolic intussusception was directly visualized in five cases as a homogeneous, water-density mass with a convex interface against bowel gas.
- In four cases, intussusception manifested as abnormal separation of gas-filled bowel loops in the upper abdomen.
- The supine cross-table lateral radiograph prospectively identified intussusception in nine out of 12 cases.
Conclusions:
- The supine cross-table lateral abdominal radiograph is a valuable tool for diagnosing ileocolic intussusception in infants.
- Specific radiographic findings, including a water-density mass and abnormal bowel gas patterns, aid in detection.
- This imaging modality can be effectively utilized in the prospective diagnosis of infant intussusception.
Abstract:
The ability to detect ileocolic intussusception on the supine cross-table lateral radiograph of the abdomen in infants was prospectively evaluated in 12 cases (including two recurrences) over a 2-year period. The intussusceptions (including one recurrence) were directly depicted on five radiographs as a homogeneous water-density mass producing a convex interface with bowel gas at the anterior part of the abdomen. In another four patients, the intussusception produced an inappropriate craniocaudal separation of gas-filled bowel loops in the upper part of the abdomen, caudal to the liver shadow. The intussusception was prospectively recognized on the supine cross-table lateral radiograph in nine of 12 cases.