Diagnostic Accuracy of Abdominal Ultrasound in Pediatric Patients with Signs and Symptoms of Intussusception

To evaluate the diagnostic performance of abdominal ultrasonography, specifically its positive predictive value, in children younger than 36 months presenting with suspected intussusception to the emergency department of a major tertiary care center in Saudi Arabia, and to describe the associated clinical and sonographic features.

This retrospective study reviewed the medical records and radiological findings of 150 pediatric patients aged less than 36 months who presented with suspected intussusception to the emergency department in a major tertiary care center in Saudi Arabia between 2005 and 2015. Ultrasound was used as the initial diagnostic modality, and findings were confirmed using contrast enema, computed tomography scan, or intraoperative findings when applicable.

Out of 150 suspected cases, 36 patients(24.0%) were confirmed to have intussusception. All 36 ultrasound-positive cases were subsequently confirmed by contrast enema, computed tomography, or surgery, giving a positive predictive value of 100% (36/36). Because the 114 ultrasound-negative patients were classified on the basis of clinical course rather than an independent reference standard, sensitivity, specificity, and negative predictive value could not be validly estimated and are not reported. Vomiting and bloody stool were significantly associated with confirmed diagnosis; no significant association was found with gender.

In this single-center retrospective cohort, a positive abdominal ultrasound reliably predicted confirmed intussusception, supporting its established role as the first-line imaging modality for suspected pediatric intussusception. Although this regional data add local confirmation but, given the retrospective design and the absence of an independent reference standard for ultrasound-negative cases, it should be interpreted with caution.