Related Experiment Video
Updated: Jan 22, 2026
Point-of-Care Ultrasound: A Review of Ultrasound Parameters for Predicting Difficult Airways
Published on: April 7, 2023
Ultrasound-Based Prediction Model for Air Enema Failure in Pediatric Ileocolic Intussusception: Comparison of
Sung-Ha Kim1, Jae-Hyun Kwon, So-Hyun Paek
1Department of Emergency Medicine, Bundang CHA Medical Center, CHA University, Seongnam-si, South Korea.
Insights
Ultrasound features can predict failed intussusception reduction in children. A validated model using specific ultrasonographic findings improves prediction and supports point-of-care ultrasound (POCUS) use in pediatric emergencies.
Area of Science:
- Pediatric Radiology
- Emergency Medicine
- Gastroenterology
Background:
- Pediatric ileocolic intussusception diagnosis is challenging due to atypical presentations.
- Enema reduction is standard, but failure necessitates surgery.
- Identifying predictors of reduction failure is crucial for timely intervention.
Purpose of the Study:
- Identify ultrasonographic predictors of enema reduction failure in pediatric intussusception.
- Develop and validate a predictive model for reduction failure.
- Assess the utility of point-of-care ultrasound (POCUS) in this context.
Main Methods:
- Retrospective study of children undergoing air enema reduction for intussusception.
- Logistic regression analysis to identify predictors of reduction failure.
- Model validation and comparative analysis of radiologist-performed ultrasound versus POCUS.
Main Results:
- Lymph nodes, invagination length, hypoechoic ring thickness, and low vascularity on ultrasound predicted failure.
- A 6-feature ultrasound model showed good predictive performance and 100% sensitivity upon validation.
- Radiologists identified risk features more comprehensively than pediatric emergency physicians using POCUS.
Conclusions:
- Ultrasound features are reliable predictors of enema reduction failure in pediatric intussusception.
- A validated predictive model enhances management decisions.
- Standardized ultrasound assessment and expanded POCUS roles are recommended for pediatric emergencies.
Objectives:
Pediatric ileocolic intussusception often presents without classic symptoms, making early diagnosis and management challenging. While the enema reduction is the standard treatment, failed reduction may lead to surgical intervention. This study aimed to identify predictors of reduction failure focusing on ultrasonographic features, to develop a predictive model and to assess capabilities of point-of-care ultrasound (POCUS).
Methods:
We conducted a retrospective study at a pediatric emergency center from January 2020 to December 2024. Children who underwent air enema reduction for ileocolic intussusception were included. Univariable and multivariable logistic regression analyses were performed to identify predictors of reduction failure. A prediction model was constructed using ultrasound features and validated using a distinct cohort. Paired comparative analysis between POCUS and radiologist-performed ultrasound was performed.
Results:
Among 179 children, 35 experienced failure. Most of the demographic and symptom-based variables were not significantly associated with outcomes. Radiologist-performed US revealed that lymph nodes around the lesion, greater invagination length, hypoechoic ring thickness, and suspected low vascularity were associated with failure. A multivariable logistic regression model using 6 ultrasound features demonstrated good predictive performance. External validation with 58 patients yielded good predictive performance and 100% sensitivity. Comparative analysis showed that radiologists more frequently assessed long-axis views and vascularity, identifying risk features more comprehensively than pediatric emergency physicians.
Conclusions:
Ultrasound-based features are possibly more reliable predictors of enema reduction failure in pediatric emergency settings. Our validated model and comparative analysis highlight the importance of standardized ultrasound assessment and support the expanded role of POCUS.
More Related Videos
05:04Author Spotlight: Evaluating Clinicians' Adoption of Ultrasound-Guided Vascular Cannulation Through Simulation Training
Published on: August 9, 2024
05:51Author Spotlight: Unraveling the Impact of Mechanical Ventilation on Diaphragm Function and Patient Outcomes
Published on: November 3, 2023
Related Concept Videos
01:25Ultrasound II: Endoscopic Ultrasound and FibroScan
Endoscopic Ultrasound (EUS):
01:20Ultrasound I: Abdominal Ultrasonography
Abdominal ultrasonography, commonly known as abdominal ultrasound, is a vital, non-invasive medical imaging technique widely used in healthcare.
Procedure:
This diagnostic tool allows the clinician to visually inspect internal structures within the abdomen, including vital organs such as the liver, gallbladder, pancreas, kidneys, and spleen.
The abdominal ultrasound process begins with applying a special gel to the patient's skin over the abdomen. This gel enhances the...
01:19Assessing Blood pressure using a doppler ultrasound
Pre-Procedural Guidelines for Doppler Ultrasound Blood Pressure Assessment:
Preparation of Equipment:
02:57The Sense of Self: Reflected Self-Appraisal and Social Comparison
01:23Lower GI Series: Barium Enema
Procedure Details
The examination begins by inserting a lubricated rectal tube into the patient's rectum to administer a radiopaque barium solution. The barium flow is carefully...
01:26Pharmacokinetic Models: Comparison and Selection Criterion
Physiological models take a detailed approach by considering specific molecular processes. They can predict drug distribution, metabolism, and elimination changes, providing a comprehensive understanding of how drugs interact with the body.