Sonography of pediatric small-bowel intussusception: Differentiating surgical from nonsurgical cases

Martha M. Munden, John F. Bruzzi, Brian D. Coley, Reginald F. Munden

Research output: Contribution to journalArticlepeer-review

51 Scopus citations

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 = 1 [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.

Original languageEnglish (US)
Pages (from-to)275-279
Number of pages5
JournalAmerican Journal of Roentgenology
Volume188
Issue number1
DOIs
StatePublished - Jan 2007

Keywords

  • Abdomen
  • Pediatric imaging
  • Small-bowel intussusception
  • Sonography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

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