Accuracy of Plain Radiographs to Exclude the Diagnosis of Intussusception

Roskind, Cindy G.; Kamdar, Gunjan; Ruzal-Shapiro, Carrie; Bennett, Jonathan E.; Dayan, Peter

doi:10.1097/pec.0b013e318267ea38

Cited by 16 publications

(13 citation statements)

References 21 publications

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“…Abdominal X-rays have not been good diagnostic tools although recent studies show improved success rates. 17 Clinical prediction using X-rays and other clinical features have been used to stratify risk of intussusceptions in children. 18 Emergency physician performed ultrasound examinations in diagnosing intussusceptions are promising to be a feasible option for early diagnosis of intussusceptions in children.…”

Section: Discussionmentioning

confidence: 99%

Intussusception in Children Presenting to the Emergency Department

Lochhead

Jamjoom

Ratnapalan

2013

Clin Pediatr (Phila)

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A retrospective chart review of children diagnosed with intussusceptions from March 2005 to March 2007 was conducted at a tertiary care pediatric hospital. There were 152 children with 170 episodes of intussusceptions during the study period. Around one third (30%) of children diagnosed with intussusceptions had a concurrent infection. There were 114 large bowel intussusceptions, with a mean age of 27 months (SD = 25) and a success rate of 91% for air enema reductions. Bowel resection was performed in 8.8% of children with large bowel intussusceptions. Small bowel intussusceptions (n = 38) were associated with gastrostomy tubes in 42% (n = 16) of patients, and 81% needed tube shortening. The varying age range of many children diagnosed with intussusceptions and the high incidence of intercurrent illnesses and fever in our study alert health professionals to suspect intussusceptions in children presenting with abdominal pain or crying.

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Section: Discussionmentioning

confidence: 99%

Intussusception in Children Presenting to the Emergency Department

Lochhead

Jamjoom

Ratnapalan

2013

Clin Pediatr (Phila)

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“…12 Studies were excluded from this review, if children had prior abdominal surgery, prior history of intussusception, or conditions associated with a lead point. [13][14][15] In addition, children with prior abnormal abdominal radiograph were excluded from our review. Such children would have conditions such as necrotizing enterocolitis, cystic fibrosis, or chronic malabsorptive syndrome.…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

Evidence-Based Diagnostic Test Accuracy of History, Physical Examination, and Imaging for Intussusception

Hom¹,

Kaplan²,

Fowler

et al. 2020

Pediatr Emer Care

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Introduction: Intussusception is the most common cause of pediatric small bowel obstruction. Timely and accurate diagnosis may reduce the risk of bowel ischemia. We quantified the diagnostic test accuracy of history, physical examination, abdominal radiographs, and point-of-care ultrasound. Method:We conducted a systematic review for diagnostic test accuracy of history, physical examination, and imaging concerning for intussusception. Our literature search was completed in June 2019. Databases included Medline via Ovid, Embase, Scopus, and Wiley Cochrane Library. We conducted a second review of the literature up to June 2019 for any additional studies. Inclusion criteria were younger than 18 years and presenting to the emergency department for abdominal complaints, consistent with intussusception. We performed data analysis using mada, version 0.5.8. We conducted univariate and bivariate analysis (random effects model) with DerSimonian-Laird and Reitsma model, respectively. QUADAS-2 was used for bias assessment. Results:The literature search identified 2639 articles, of which 13 primary studies met our inclusion criteria. Abdominal pain, vomiting, and bloody stools had positive likelihood ratios LR(+) between 1 and 2, whereas the negative likelihood ratio, LR(−), ranged between 0.4 and 0.8. Abnormal abdominal radiograph had LR(+) of 2.5 and LR(−) of 0.20, whereas its diagnostic odds ratio was 13. Lastly, point-of-care ultrasound had LR(+) of 19.7 and LR(−) of 0.10. The diagnostic odds ratio was 213.Conclusions: History and physical examination had low diagnostic test accuracy. Abdominal radiographs had low diagnostic test accuracy, despite moderate discriminatory characteristics. Point-of-care ultrasound had the highest diagnostic test accuracy to rule in or rule out intussusception.

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“…4,[8][9][10][11][12][13][14] Others have found the presence of air in the ascending colon on three radiographic views (supine, prone, and left lateral decubitus) to have 100% negative predictive value, although this finding was present in a minority of cases. 15 Given the potentially significant proportion of the children with intussusception and normal plain radiographs, further imaging investigation is warranted when this diagnosis remains a clinical suspicion.…”

Section: Abdominal Filmsmentioning

confidence: 99%

Diagnosis and Management of Pediatric Patients with Intussusception

Smith

Maloney

2019

Dig Dis Interv

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Intussusception is one of the most common cause of bowel obstruction in infancy. While surgical intervention is sometimes needed, the primary modality for the reduction of intussusception is pneumatic or air enema. This is highly successful in the reduction of ileocolic intussusception with 90% success rate. Here we review the presentation, pathophysiology, appropriate radiographic studies and findings, and fluoroscopic reduction technique.

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Accuracy of Plain Radiographs to Exclude the Diagnosis of Intussusception

Abstract: The presence of air in the ascending colon on the 3-view abdominal radiograph can decrease the likelihood of or exclude intussusception. When clinical suspicion is low, the presence of specific criterion on a 3-view abdominal radiograph series may obviate the need for further studies.

Cited by 16 publications

References 21 publications

Intussusception in Children Presenting to the Emergency Department

Intussusception in Children Presenting to the Emergency Department

Evidence-Based Diagnostic Test Accuracy of History, Physical Examination, and Imaging for Intussusception

Diagnosis and Management of Pediatric Patients with Intussusception

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