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Predicting bowel necrosis in pediatric acute intussusception using roundness and other related factors

Xin-Xin Xu1, Yi-Jin Cai2, Jia Liu3

  • 1Department of Ultrasound, Affiliated Children's Hospital of Jiangnan University（Wuxi Children's Hospital, Wuxi, 214023, Jiangsu, China. szwqianfeng@126.com.

BMC Pediatrics
|October 22, 2025
PubMed

Insights

In pediatric intussusception, specific ultrasound findings like roundness and reduced blood flow signal are key indicators of intestinal necrosis. These factors help predict the severity and guide treatment decisions for affected children.

Area of Science:

  • Pediatric Surgery
  • Diagnostic Imaging
  • Gastroenterology

Background:

  • Intussusception is a common surgical emergency in children.
  • Intestinal necrosis is a severe complication of intussusception, requiring prompt diagnosis.
  • Identifying predictive factors for intestinal necrosis is crucial for timely intervention.

Purpose of the Study:

  • To investigate the risk factors associated with intestinal necrosis in pediatric intussusception.
  • To identify ultrasound and clinical features that predict bowel necrosis.

Main Methods:

  • Retrospective analysis of clinical data from children with intussusception and intestinal necrosis.
  • Comparison with a control group treated successfully with air enema.
  • Analysis of ultrasound manifestations and clinical features using logistic regression.

Main Results:

  • Children with bowel necrosis were younger (<12 months) and presented with reduced blood flow signal (
  • Higher values for roundness, concentric ring thickness, intussuscepted segment length, head-to-neck diameter ratio, bowel wall thickness, and neutrophil-to-lymphocyte ratio (NLR) were observed in the necrosis group.
  • Logistic regression identified roundness (OR=1.397) and blood flow signal

Conclusions:

  • Ultrasound parameters, specifically roundness, are significant predictors of bowel necrosis in pediatric intussusception.
  • Blood flow signal grading is another independent predictor for diagnosing bowel necrosis in this population.
Abstract

Keywords:
Bowel necrosisIntussusceptionUltrasonography

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