Ultrasonographic findings of intussusception in pediatric cases.

PURPOSE

We aimed to characterize, by ultrasonography (US), the aspects, locations and the dimensions of intussusceptions in pediatric cases and to compare these data with the clinical findings and therapeutical outcomes.

MATERIALS AND METHODS

We retrospectively evaluated abdominal US examinations and clinical data of 13 consecutive pediatric patients with intussusceptions. Patients are grouped according to the type of intussusceptions (ileocolic intussusceptions and intussusceptions with colocolic involvement) and according to the modality of treatment (surgical and non-surgical).

RESULTS

Median age was 24 months (range 5-108 months). Eleven cases were surgically treated because of delayed referral. For all cases the mean diameter+/-SD of intussusception was 30+/-5 mm and mean length+/-SD was 59+/-21 mm. For ileocolic intussusceptions (n=9/11), mean diameter+/-SD was 29.1+/-4.4 mm and mean length+/-SD was 61.7+/-18.1 mm. The right upper quadrant of abdomen was the most common location for ileocolic intussusceptions (n=7/9), the rest were located in paraumbilical regions (n=2/9). For two cases of intussusceptions with colocolic involvement (ileocolocolic and colocolic intussusceptions located in right upper quadrant and left lower quadrant, respectively), mean diameter+/-SD was 37.5+/-0.7 mm and mean length+/-SD was 75.5+/-21.9 mm. The difference between mean diameters of ileocolic intussusceptions and intussusceptions with colocolic involvement was statistically significant (p =0.03), whereas the difference between mean lengths of these two groups was not statistically significant (p=0.36). For surgically treated cases (n=11/13), mean diameter+/-SD of intussusception was 30.6+/-5.2 mm and the mean length +/-SD was 64.2+/-18.5 mm. For non-surgically treated cases (n=2/13), with intussusceptions located in right lower quadrant, mean diameter+/-SD of intussusception was 27+/-4.2 mm and the mean length+/-SD was 32.5+/-10.6 mm. The difference between mean diameters of surgically and non-surgically treated cases was not statistically significant (p=0.37), whereas the difference between mean lengths of these two groups was statistically significant (p=0.04).

CONCLUSIONS

A very good correlation between US and surgical findings was obtained. US should be used in all pediatric patients clinically suspected for intussusception. A relatively large, target-like and sandwich-like, incompressible intraabdominal bowel mass having the above mentioned dimensions should be looked for on US examination.