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Point-of-care ultrasound diagnosis of pediatric intussusception: a case series
Gregory Zandrow1, Ryan C Gibbons2, Thomas G Costantino1
1Department of Emergency Medicine, Lewis Katz School of Medicine At Temple University, 1316 West Ontario Street, Philadelphia, PA, 19140, USA.
Insights
Point-of-care ultrasound (POCUS) aids rapid diagnosis of intussusception, an intestinal emergency. This imaging technique is crucial for timely treatment, especially in non-pediatric emergency settings.
Area of Science:
- Pediatric Gastroenterology
- Emergency Medicine
- Diagnostic Imaging
Background:
- Intussusception is a critical intestinal emergency where one segment telescopes into another.
- Delayed diagnosis of intussusception significantly elevates risks of obstruction, ischemia, and perforation.
- Nonspecific symptoms often lead to missed diagnoses in nearly 50% of initial presentations.
Purpose of the Study:
- To highlight the utility of point-of-care ultrasound (POCUS) in expediting intussusception diagnosis.
- To demonstrate POCUS as a valuable tool in non-pediatric emergency departments.
- To emphasize the importance of prompt diagnosis for effective intussusception management.
Main Methods:
- Case report of two pediatric patients diagnosed with intussusception.
- Utilized point-of-care ultrasound (POCUS) for rapid diagnostic assessment.
- Management and treatment expedited by POCUS findings.
Main Results:
- Point-of-care ultrasound (POCUS) facilitated prompt and accurate diagnosis in both pediatric cases.
- Expedited diagnosis led to timely treatment, preventing potential complications.
- Ultrasound proved effective in a non-pediatric specialized emergency setting.
Conclusions:
- Point-of-care ultrasound (POCUS) is a highly accurate and accessible tool for diagnosing intussusception.
- Implementing POCUS in emergency departments can significantly improve patient outcomes.
- Early detection and treatment are paramount for managing this surgical emergency effectively.
Abstract:
Intussusception is an intestinal emergency caused by the telescoping of proximal bowel into an adjacent distal bowel segment. Nearly 50% of cases are missed on initial presentation leading to an increased risk of intestinal obstruction, ischemia, and perforation. The authors present two cases of pediatric intussusception whereby point-of-care ultrasound expedited the diagnosis and treatment in a non-pediatric dedicated emergency department. Given the risks of an undiagnosed intussusception and its nonspecific presentations, a prompt and precise diagnosis remains crucial to its successful management. The ubiquity and accuracy of point-of-care ultrasound make it an ideal adjunct for the diagnosis of intussusception.
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