Sonography of Pediatric Small-Bowel Intussusception: Differentiating Surgical from Nonsurgical Cases
- 1 January 2007
- journal article
- research article
- Published by American Roentgen Ray Society in American Journal of Roentgenology
- Vol. 188 (1), 275-279
- https://doi.org/10.2214/ajr.05.2049
Abstract
OBJECTIVE. The purpose of this study was to determine whether there are clinical or sonographic findings that can be used to differentiate benign self-limited small-bowel intussusception from pathologic small-bowel intussusception that necessitates surgical intervention. MATERIALS AND METHODS. A retrospective search was performed of abdominal sonograms obtained at two institutions between January 1996 and June 2005. Sonographic findings were correlated with medical and surgical records. RESULTS. A total of 35 cases of isolated small-bowel intussusception were found. Thirteen (37%) of these cases necessitated surgical intervention, and 22 (63%) of the cases were benign and self-limiting. Patients with self-limiting intussusception were younger than patients with intussusception necessitating surgical intervention (mean, 4.2 vs 7.5 years; p = 0.0327). Abdominal sonograms depicted ascites and small-bowel obstruction significantly more frequently in patients with small-bowel intussusception necessitating surgery (n = 7 [54%] for each finding) than in patients with self-limiting intussusception (n =2 [9%], n =0) (p = 0.006 and p = 0.0003, respectively). At sonography, patients who later underwent surgical intervention had small-bowel intussusception of significantly greater length (mean, 7.3 cm) than those treated conservatively (mean length, 1.9 cm) (p < 0.0001). Intussusception length greater than 3.5 cm was considered a sensitive and specific independent predictor of the need for surgery (sensitivity, 93%; specificity, 100%). CONCLUSION. When small-bowel intussusception is detected in infants and children undergoing abdominal sonography, intussusception length greater than 3.5 cm is a strong independent predictor of the need for surgical intervention.Keywords
This publication has 15 references indexed in Scilit:
- IntussusceptionPediatric Radiology, 2004
- Twenty-one cases of small bowel intussusception: the pathophysiology of idiopathic intussusception and the concept of benign small bowel intussusceptionPediatric Surgery International, 2004
- US Features of Transient Small Bowel Intussusception in Pediatric PatientsKorean Journal of Radiology, 2004
- Distinguishing Features of Self-limiting Adult Small-Bowel Intussusception Identified at CTRadiology, 2003
- Dünndarminvaginationen im Kindesalter: Diagnostik und BedeutungKlinische Padiatrie, 2003
- Evaluation of Patients with Jejunostomy Tubes: Imaging FindingsRadiology, 2002
- Small Bowel Intussusception in Symptomatic Pediatric Patients: Experiences with 19 Surgically Proven CasesWorld Journal of Surgery, 2002
- Sonographic Features of Small‐bowel Intussusception in Pediatric PatientsAcademic Emergency Medicine, 2001
- Spontaneous reduction of intussusception: clinical spectrum, management and outcomePediatric Radiology, 2000
- The clinical implications of non-idiopathic intussusceptionPediatric Surgery International, 1998