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Practical Imaging Strategies for Intussusception in Children.

Domen Plut1,2, Grace S Phillips3, Patrick R Johnston4

  • 1Clinical Institute of Radiology, University Medical Centre Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia.

AJR. American Journal of Roentgenology
|October 21, 2020
PubMed
Summary

Ultrasound is the top choice for diagnosing pediatric intussusception due to its accuracy and safety. Both fluoroscopy-guided pneumatic and ultrasound-guided hydrostatic enemas are effective for intussusception reduction.

Keywords:
childenemafluoroscopyintussusceptionultrasound

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Area of Science:

  • Pediatric Radiology
  • Gastrointestinal Imaging
  • Medical Diagnostics

Background:

  • Intussusception is a frequent cause of bowel obstruction in young children.
  • Radiology plays a critical role in the diagnosis and therapeutic management of intussusception.
  • Current evidence on optimal radiologic management practices for pediatric intussusception requires synthesis.

Purpose of the Study:

  • To systematically review and summarize the evidence on best practices in the radiologic management of pediatric intussusception.
  • To identify preferred imaging modalities for diagnosis and effective reduction techniques.

Main Methods:

  • Systematic review of available literature.
  • Analysis of diagnostic accuracy of imaging modalities.
  • Evaluation of safety and efficacy of reduction techniques.

Main Results:

  • Ultrasound (US) demonstrates high diagnostic accuracy for intussusception and avoids ionizing radiation, making it the preferred diagnostic tool.
  • Fluoroscopy-guided pneumatic enema and US-guided hydrostatic enema are equally safe and effective for intussusception reduction.
  • Areas for further research include US-guided pneumatic enema, sedation/anesthesia effects, and management of intussusception with pathologic lead points.

Conclusions:

  • Ultrasound is the preferred imaging modality for diagnosing pediatric intussusception.
  • Both fluoroscopy-guided pneumatic and US-guided hydrostatic enemas are reliable and safe for intussusception reduction.
  • Further research is needed to optimize intussusception management, particularly concerning newer techniques and specific patient populations.