Suspecting Intussusception and Recurrence Risk Stratification Using Clinical Data and Plain Abdominal Radiographs

Area of Science:

• Pediatric Radiology
• Gastrointestinal Imaging
• Abdominal Pain Diagnostics

Background:

• Plain abdomen radiograph (AXR) is frequently used for differential diagnosis in pediatric patients presenting with abdominal pain.
• Ultrasonography is the gold standard for diagnosing intussusception, but AXR remains a common initial imaging modality.

Purpose of the Study:

• To analyze AXR findings and clinical data in pediatric intussusception patients.
• To identify early AXR characteristics associated with intussusception diagnosis and recurrence after reduction.

Main Methods:

• Retrospective review of 398 pediatric patients diagnosed with intussusception (ICD-10 code K56.1) between 2011 and 2018.
• Evaluation of six AXR features: absent ascending colon gas, absent transverse colon gas, target sign, meniscus sign, mass, and ileus.
• Comparison of clinical data and AXR features between patients with single intussusception episodes and those with recurrence after air reduction.

Main Results:

• Absent ascending colon gas was the most common AXR finding in intussusception (63.9%), followed by mass (29.1%).
• All six evaluated AXR features were more frequent in the recurrence group.
• Absent transverse colon gas showed the strongest association with recurrence (odds ratio, 2.964; p=0.008).

Conclusions:

• Absence of ascending colon gas is the most frequent AXR finding in pediatric intussusception.
• The presence of specific AXR findings, particularly absent transverse colon gas, may predict recurrence.
• Extended observation after reduction is recommended for intussusception patients with suggestive AXR findings to monitor for recurrence.