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Ultrasound in the diagnosis and exclusion of intussusception
1Department of Radiology, Longford/Westmeath General Hospital, Mullingar, Co. Westmeath.
Insights
Ultrasound is a highly accurate tool for diagnosing intussusception in children, with 100% sensitivity. This imaging method aids in prompt treatment and reduces unnecessary procedures for intestinal obstruction.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
- Surgical Pediatrics
Background:
- Intussusception is a primary cause of intestinal obstruction in infants and children.
- Advances in ultrasound imaging and pneumatic reduction have improved treatment outcomes.
Purpose of the Study:
- To prospectively evaluate the diagnostic and exclusionary value of ultrasound for intussusception.
- To assess ultrasound's role in a peripheral pediatric setting over a four-year period.
Main Methods:
- Prospective study of 24 pediatric patients with suspected intussusception.
- Utilized ultrasound for diagnosis and exclusion.
- Analyzed sensitivity, specificity, and enema reduction success rates.
Main Results:
- Ultrasound demonstrated 100% sensitivity and 89% specificity, with no missed cases of intussusception.
- Enema reduction was successful in 76% of diagnosed cases.
- Factors predicting enema failure included rectal bleeding and symptom duration >24 hours.
Conclusions:
- Ultrasound is a rapid, sensitive, and effective screening tool for diagnosing and excluding intussusception in children.
- It facilitates timely management of intestinal obstruction.
- Further research could explore predictors of enema reduction success.
Abstract:
Intussusception is a major cause of intestinal obstruction in infancy and childhood. Improved results of treatment have followed the increased use of ultrasound imaging and pneumatic reduction. We prospectively studied the value of ultrasound in both the diagnosis and exclusion of intussusception in a peripheral paediatric unit over a four year period from October 1990 to October 1994. In all, 24 patients had a suspected clinical diagnosis of intussusception of which 19 had typical ultrasound findings. The male to female ratio was 8:11 and age at presentation ranged from 2 to 38 months (mean 11.4 months). There were no false negatives and 2 false positives giving a sensitivity to 100% and specificity of 89%. Thus no intussusception was missed by ultrasound examination. Enema reduction was successful in 76% of cases and factors associated with failure of enema reduction included passage of blood per rectum and symptoms for greater than 24 hours. We conclude that ultrasound should be used as a rapid and sensitive screening procedure in the diagnosis and exclusion.