Transient versus surgically managed small bowel intussusception in children: Role of ultrasound (original) (raw)
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Small Bowel Intussusceptions by Ultrasound
2018
The purpose of this study was to evaluate the typical ultra-sonographic findings of transient Small Bowel Intussusceptions (SBI)) in paediatrics. 6 transient SBI (male: female =4:2, age: 7–120 months (mean 38.months)) patients diagnosed on ultrasonography were retrospectively evaluated. The findings of location, diameter, thickness of outer rim, and inclusion of mesenteric lymph nodes within intussusceptions were compared. In the transient SBI, the head of intussusceptions was located in the right lower quadrant (RLQ) in 3 (50%), the right upper quadrant (RUQ) in 1 (16,1%) and the periumbilical area in 2 (33,4%) cases. The anteroposterior (AP) diameter ranged from 0.9–2.5 cm (mean 1.38 cm), and thickness of outer rim ranged from 0.10–0.34 cm (mean 0.26 cm). No mesenteric lymph nodes were contained within the intussuscipiens. In conclusion, the transient SBI occurs predominantly in the RLQ or periumbilical region has a smaller AP diameter, a thinner outer rim, and dose not contain me...
Ultrasound in Medicine & Biology, 2020
The main aim of the study was to elaborate on the various ultrasonographic parameters that can be used for definite differentiation of ileocolic, obstructive small-bowel and transient small-bowel intussusceptions (SBI). In this study, 90 children (63 boys and 27 girls) with suspected intussusception were evaluated. Of these, 54 cases were diagnosed as obstructive intussusceptions (33 ileocolic and 21 ileoileal), 15 cases were classified as transient SBIs and 21 cases were negative for intussusception. The mean fat core diameter was 1.45 § 0.32 cm for ileocolic versus 0.37 § 0.06 cm for obstructive SBI versus 0.29 § 0.08 cm for transient SBI (p < 0.001). The mean lesion diameter was 3.23 § 0.08 cm for ileocolic intussusceptions and 2.12 § 0.038 cm for SBI (p < 0.001), and the ratio of inner fat core to outer wall thickness was greater than 1 for ileocolic intussusceptions and less than 1 for SBI. A statistically significant difference was found between segmental invagination of transient versus obstructive SBIs with mean values of 1.93 § 0.39 cm and 3.17 § 0.25 cm, respectively, and an "optimal" threshold at 2.5 cm.
Sonographic Features of Small-bowel Intussusception in Pediatric Patients
Academic Emergency Medicine, 2001
Objective: Small-bowel intussusception (SBI) for pediatric patients is unusual and difficult to diagnose preoperatively. This study sought to determine the sonographic findings of pediatric SBI. Methods: The sonographic features and surgical findings of 13 pediatric patients (7 boys, 6 girls; age range 4 months-15 years; average age 4 years and 2 months) with SBI encountered in the authors' hospital over a 12-year period were retrospectively reviewed. Results: Most of the patients presented with nonspecific symptoms, including vomiting, abdominal pain, and/or irritable crying. Sonographic screening in the emergency department revealed a doughnut or crescentin-doughnut sign, or a multiple-concentric-rings sign for 11 of the 13 patients, and the lesions appeared short. Eight lesions were found in the paraumbilical or left abdominal regions. Sonographic measurement
Transient small bowel intussusceptions: ultrasound findings and clinical significance
Abdominal Imaging, 2006
Purpose: To study the ultrasound (US) findings and clinical significance of transient small bowel intussusceptions (TSBI) in adults and children. Methods: Clinical records and US findings of 108 consecutive patients of intestinal intussusception diagnosed on US between August 1995 and August 2004 were reviewed. In all cases, the length, diameter, wall thickness and color Doppler study of the bowel segment involved in intussusception were evaluated. Subsequent follow-up scans were performed at 30 min, 3 days and 2 weeks. Patients were clinically followed up for 6 months. Results: Forty-one patients were diagnosed as TSBI. Thirty-six intussusceptions were incidentally detected during US performed for some unrelated disease or vague abdominal symptom. Five patients presented with signs of obstruction at the time of the initial US diagnosis; however, the intussusceptions resolved without any treatment and were not detected on follow-up scans. Sixty-seven symptomatic patients required surgical intervention. Conclusion: Incidentally detected, small bowel intussusceptions without an identifiable pathological lead point, with a normal wall thickness, a length of less than 3.5 cm, normal nondilated proximal bowel and normal vascularity on color Doppler reduce spontaneously and are of no clinical significance.
Journal of Ultrasonography
Aim of the study: Intussusception is a common paediatric emergency which can be diagnosed with relative certainty by ultrasonography in trained hands. Both the ileocolic and small-bowel intussusception have overlapping clinical features and imaging findings on ultrasound. The aim is to differentiate between both subtypes based on selective differentiating features which should always be looked for while performing an ultrasound examination in suspected cases. Differentiating between the two subtypes is essential, since patient management may differ depending on the subtype. Case description: We present a case of a 12-year-old boy who presented to our hospital with pain in the abdomen. An emergency ultrasound revealed findings suggestive of small- bowel intussusception. A brief description of the differentiating points from the ileocolic subtype is also described. Conclusions: Based on the features described, it is possible to confidently differentiate between the two subtypes, which...
A report of 6 children with small bowel intussusception that required surgical intervention
Journal of Pediatric Surgery, 2006
Background/Purpose: We aim to justify the need for surgical intervention in our patients with childhood small bowel intussusceptions (SBIs) and review the current concepts in childhood SBI. Materials and Methods: We retrospectively reviewed the clinical charts of all patients with surgically confirmed SBI between July 1999 and October 2002. Demographic data, clinical presentation and investigations, operative and pathologic findings, and outcome were analyzed. Results: Of 173 patients with intussusception, 6 (3.5%) were diagnosed with SBI. Median age was 11 months. Ultrasonography revealed intussusceptions in all patients, but only 1 was diagnosed with SBI. Air enema reductions were attempted in 4 of 6 patients with all ending up in failure and surgery. Surgery revealed ileoileal intussusceptions in 4 patients and jejunojejunal intussusceptions in 2 patients. Two patients had long intussusceptions measuring between 30 and 50 cm in length. Five patients had pathologic lead points, and bowel complications occurred in 2 patients. All underwent bowel resection and primary anastomosis. Conclusion: Despite reports on spontaneous reduction of SBI, surgery was unavoidable in all our patients with SBI because of the presence of pathologic lead points and/or bowel complications. Air enema reduction was ineffective in SBI. Due caution should be exercised when selecting patients for expectant management.
Transient small-bowel intussusception in children on CT
Pediatric Radiology, 2003
Intussusception is a common gastrointestinal emergency in the pediatric population. Most diagnosed intussusceptions are ileocolic. Intrinsic small-bowel (enteroenteric) intussusceptions are much less frequently diagnosed. The purpose of this study was to determine the frequency and significance of small-bowel intussusceptions diagnosed in children by computed tomography (CT).
Intussusception in children: not only surgical treatment
Journal of Pediatric and Neonatal Individualized Medicine, 2017
Introduction: Intussusception is the commonest cause of acute intestinal obstruction in children. Failure of timely diagnosis and treatment results in a surgical emergency leading to fatal outcome. The classic triad of symptoms is seen in less than one-third of the children affected. Aim of this study was to evaluate the comprehensive management of intussusception in children, evaluating the outcome of conservative treatment with hydrostatic ultrasound reduction and surgery. Material and methods: A retrospective analysis was conducted including pediatric patients (up to 14 years old) with diagnosis of bowel intussusception. The management and treatment depended on the patients’ situation: for children in good general conditions initial hydrostatic reduction under continuous ultrasonographic monitoring was attempted; if severe dehydration and/or septic shock was observed, the conservative treatment was contraindicated and direct surgical treatment was performed. Result: A total of 4...
Ultrasound-guided reduction of ileocolic intussusception in children
Paediatrics Today, 2016
Objective-To determine the success rate of the newly introduced method of ultrasound guided hydrostatic reduction in detected ileocolic intussusception by retrospective analysis. Materials and methods-Analysis was performed on all diagnosed ileocolic intussusceptions during the period of December 2013 to November 2015 at the Department for pediatric Radiology of the Children's Hospital Zagreb. In this period of time 34 patients were diagnosed with ileocolic intussusception. Ultrasound guided hydrostatic reduction was performed in 31 patients. We performed ultrasound guided hydrostatic reposition using saline solution warmed at body temperature. Saline was applied per rectum. When the intussusceptum crossed the ileocecal valve, the reposition was considered successful. Results-Out of 34 patients, three patients were treated with an urgent surgical procedure, while ultrasound guided hydrostatic reduction was performed in 31 patients. The non-surgical procedures were successful in all cases and complete reductions of intussusception were achieved in all 31 patients. In three patients, reinvagination occurred within the first 48 hours. Conclusion-Ultrasound guided hydrostatic reduction of ileocolic intussusceptions in children is a very simple and effective technique. The success rate was 91.2% (31/34). The recurrence rate was 8.8%.
INTESTINAL INTUSSUSCEPTION IN CHILDREN: A REVIEW ON ETIOLOGY, CLINIC, DIAGNOSIS AND TREATMENT (Atena Editora), 2023
To carry out the analysis and review of available articles on intussusception in children, evaluating aspects of its etiology, diagnosis, clinic and treatment. Methodology: The study consists of a bibliographical review, with a bibliographical survey in the databases: PubMed, Analysis and online retrieval system (MedLine); Scientific Electronic Library Online (SciELO), Google Scholar and LILASCS. Literature review: Most cases are idiopathic in nature, but infections and malformations may be the basis of the disease. The clinical picture is mainly characterized by abdominal pain, irritability and crying. The best diagnostic tool is ultrasound, with high sensitivity and specificity. Treatment is usually carried out with pneumatic or hydrostatic enema, with surgical treatment aimed at complications such as necrosis and loop perforation.