Intussusception and appendicitis: What comes first?

Cocomazzi, Raffaella; Salatto, Alessia; Campanella, Vittoria; Maggipinto, Cosetta; Canale, Francesco; Indrio, Flavia; Nobili, Maria; Bartoli, Fabio

doi:10.1016/j.epsc.2021.101967

Cited by 2 publications

(2 citation statements)

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“…15 Less than 10% of intussusception cases have an identified lead point, and two thirds of pathologic lead points are identifiable on ultrasound. 16,17 Thus, POCUS takes a central role in the evaluation for clinically atypical intussusception. 18 Point-of-care ultrasound has a pooled sensitivity of 96% and pooled specificity of 96%, with 1 study showing a specificity of 99.1%, for the diagnosis of ileocolic intussusception.…”

Section: Review Of the Literaturementioning

confidence: 99%

“…With earlier presentation to care and earlier imaging, the classic triad of abdominal pain, vomiting, and currant jelly stool is rarely seen, and bloody stool or guaiac-positive rectal examination was not shown to be predictive of intussusception 15 . Less than 10% of intussusception cases have an identified lead point, and two thirds of pathologic lead points are identifiable on ultrasound 16,17 . Thus, POCUS takes a central role in the evaluation for clinically atypical intussusception 18 …”

Section: Case Presentationmentioning

confidence: 99%

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A Surprising Lead Point in an Ileocolic Intussusception

2022

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Appendicitis and intussusception are 2 of the most common abdominal emergencies in children and have high rates of morbidity if not treated promptly. However, only rarely do they occur together. We present a case in which clinical suspicion for intussusception was not high. Point-of-care ultrasound (POCUS) was performed in the pediatric emergency department, revealing both ileocolic intussusception and appendicitis. This case reinforces the importance of maintaining a broad differential diagnosis in unclear clinical scenarios and of the potential utility of POCUS. In our case, identification of intussusception on POCUS facilitated expeditious treatment, identification of the lead point, and allowed the treating physicians to prepare for the possibility of surgical management.

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