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Pediatric ileocolic intussusception: new observations and unexpected implications
Larry A Binkovitz1, Amy B Kolbe2, Robert C Orth3
1Division of Pediatric Radiology, Mayo Clinic, 2107 Folwell Ridge St. SW, Rochester, MN, 55902, USA. binkovitz.larry@mayo.edu.
Pediatric Radiology
|September 21, 2018
Summary
Ileocolic intussusception length is uniform regardless of colon location. Distal progression is due to right colon foreshortening, not increased telescoping, suggesting poor cecal fixation.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Radiology
Background:
- Ileocolic intussusception involves the terminal ileum telescoping into the colon.
- Previous observations suggest intussusception length is consistent across different colon locations.
Purpose of the Study:
- To investigate the uniformity of ileocolic intussusception length.
- To analyze the relationship between intussusception length, colon location, symptom duration, and reducibility.
Main Methods:
- Retrospective review of ultrasound-diagnosed pediatric ileocolic intussusceptions.
- Data collected included demographics, imaging findings, symptom duration, intussusception location, and reducibility via pneumatic reduction.
Main Results:
- No significant relationship found between intussusception length and colon location or symptom duration.
- Intussusceptions were more distal with longer symptom duration.
- Successful reduction was more likely in proximal locations.
Conclusions:
- Ileocolic intussusception length is uniform, irrespective of its colon location.
- Apparent distal spread is attributed to right colon foreshortening and cecal displacement, not increased bowel telescoping.
- Reduction involves repositioning the cecum followed by bowel reduction.
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