The role of US in finding intussusception and alternative diagnosis: a report of 100 pediatric cases

초록

Background: The clinical diagnosis of intussusception remains challenging, because many children with intussusception may present with non-specific signs and symptoms, which overlap with other conditions. Therefore imaging, in particular ultrasonography (US), plays a significant role in the management of these patients. Purpose: To evaluate how US can contribute to the diagnosis in clinically suspected intussusception and finding alternative diagnosis. Material and Methods: We retrospectively reviewed reports of US examinations and medical records of 100 patients (51 boys, 49 girls; mean age, 23.0 +/- 12.1 months) who underwent abdominal US for clinically suspected intussusception. Each US study was assessed for the presence or absence of intussusception and for a possible alternative diagnosis in cases interpreted as negative for intussusception. Results: Thirty-seven patients had US findings consistent with intussusception, which was confirmed by air enema. In seven patients, US studies were normal. Alternative diagnoses were identified by US for each of the remaining 56 patients, including ileocolitis (n = 20), terminal ileitis (n = 18), mesenteric lymphadenitis (n = 13), choledochal cyst (n = 1), accessory spleen torsion (n = 1), small bowel ileus (n = 1), midgut volvulus with bowel ischemia (n = 1), and hydronephrosis (n = 1). Conclusion: With the high sensitivity and specificity of this study we conclude that US is valuable in detecting intussusception and finding the alternative diagnosis.

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