The role of abdominal x-rays in the diagnosis and management of intussusception

Smith, Douglas S.; Bonadio, William A.; Losek, Joseph D.; Walsh‐Kelly, Christine M.; Hennes, Halim M.; Glaeser, Peter W.; Melzer-Lange, Marlene; Rimm, Alfred A.

doi:10.1097/00006565-199212000-00004

Cited by 32 publications

(14 citation statements)

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“…25,26,38,40 In the present study, a highly suggestive abdominal radiograph was found to be an important independent predictor. Intussusception, however, also occurred in 21% of patients without highly suggestive radiographs, similar to what has been reported previously.…”

Section: Commentsupporting

confidence: 57%

“…In addition, the interpretation of an abdominal radiograph may vary depending on the experience of the physician reviewing the radiograph, the level of comfort with pediatric radiology, and the quality and technique of the radiograph. 2,24,26,36,39,40 In a recent prospective study of clinical predictors of intussusception, the authors identified right upper quadrant abdominal mass, rectal bleeding and the triad of intermittent abdominal pain, vomiting, and right upper quadrant abdominal mass as significantly predictive of intussusception. 13 Negative predictors were also identified, but none with sufficient accuracy to obviate evaluation with ultrasound or air or contrast enema.…”

Section: Commentmentioning

confidence: 99%

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Predictors of Intussusception in Young Children

Kuppermann¹,

O'Dea²,

Pinckney³

et al. 2000

Arch Pediatr Adolesc Med

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Objective: To identify predictors of intussusception in young children.Design: A retrospective cross-sectional study. Setting and Patients:A consecutive sample of children younger than 5 years on whom contrast enemas were performed because of suspected intussusception seen at an urban children's hospital from 1990 to 1995. Methods:We evaluated historical, clinical, and radiographic variables. Variables documented in 75% or more of the medical records and associated with intussusception (PՅ.20) in the univariate analysis were evaluated in a multiple logistic regression analysis. Variables retaining significance (PՅ.05) in the multivariate analysis were considered independent predictors of intussusception. We used bootstrap resampling techniques to validate the multivariate model.Results: Sixty-eight (59%) of the 115 patients had intussusception. Univariate predictors of intussusception included male sex, age younger than 2 years, history of emesis, rectal bleeding, lethargy, abdominal mass, and a highly suggestive abdominal radiograph. In the multivariate analysis, we identified only 4 independent predictors (adjusted odds ratio; 95% confidence interval): a highly suggestive abdominal radiograph (18.3; 4.0-83.1), rectal bleeding (17.3; 2.9-104.0), male sex (6.2; 1.2-32.3), and a history of emesis (13.4; 1.4-126.0). We identified 3 of these 4 variables (all but emesis) as independent predictors in more than 50% of 1000 bootstrap data samples.Conclusions: Rectal bleeding, a highly suggestive abdominal radiograph, and male sex are variables independently associated with intussusception in a cohort of children suspected of having this diagnosis. Knowledge of these variables may assist in clinical decision making regarding diagnostic and therapeutic interventions.Arch Pediatr Adolesc Med. 2000;154:250-255

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Section: Commentsupporting

confidence: 57%

Section: Commentmentioning

confidence: 99%

Predictors of Intussusception in Young Children

Kuppermann¹,

O'Dea²,

Pinckney³

et al. 2000

Arch Pediatr Adolesc Med

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“…Adult intussusceptions are detected using plain abdominal film, barium studies, colonoscopy, abdominal sonography, abdominal CT, angiography and magnetic resonance imaging[11,13,14]. Although there are several diagnostic imaging techniques, as mentioned above, an abdominal CT scan is the most commonly used and accurate diagnostic modality[9,13-15]. CT shows “target” or “sausage”-shaped lesions, while also defining the location, nature and relationship of the lesion to surrounding tissues with an accuracy that ranges from 60% to 100%[3,9,13,15].…”

Section: Discussionmentioning

confidence: 99%

“…Although there are several diagnostic imaging techniques, as mentioned above, an abdominal CT scan is the most commonly used and accurate diagnostic modality[9,13-15]. CT shows “target” or “sausage”-shaped lesions, while also defining the location, nature and relationship of the lesion to surrounding tissues with an accuracy that ranges from 60% to 100%[3,9,13,15]. Abdominal ultrasonography has also been successful in diagnosing intussusception, especially if a palpable mass is found[16].…”

Section: Discussionmentioning

confidence: 99%

Ileocolic intussusception caused by a lipoma in an adult

Lee

Choe

2017

WJCC

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Intussusception is rarely observed in adults. Adult cases account for only 5% of all cases of intussusceptions and almost 1%-5% of bowel obstruction cases. The etiology, presentation and management of intussusception in adults are different from those in children. The clinical presentation in adults often includes nonspecific signs and symptoms, thereby complicating differential diagnosis from other causes of abdominal pain. We report a 29-year-old Asian woman who visited our emergency department with complaints of fever associated with epigastric pain since one day. Abdominal computed tomography demonstrated ileocolic intussusception, and laparoscopic small bowel luminal mass resection was performed. Histopathology report confirmed a 3.5 cm × 2.7 cm submucosal lipoma in the terminal ileum. Sufficient vigilance and appropriate investigations are important for prompt diagnosis and surgical referral of patients to enable favorable outcomes. A computed tomography scan can be a helpful modality in establishing a diagnosis.

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“…For intussusception, however, the use of plain radiographs remains controversial [149,150], because the diagnostic accuracy is about 25% to 50% [147,151,152]. Nevertheless, the following radiographic findings have become almost pathognomonic for intussusception:…”

Section: Laboratory and Diagnostic Studiesmentioning

confidence: 99%

Essential Diagnosis of Abdominal Emergencies in the First Year of Life

Louie

2007

Emergency Medicine Clinics of North America

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The role of abdominal x-rays in the diagnosis and management of intussusception

Cited by 32 publications

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Predictors of Intussusception in Young Children

Predictors of Intussusception in Young Children

Ileocolic intussusception caused by a lipoma in an adult

Essential Diagnosis of Abdominal Emergencies in the First Year of Life

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