Ultrasound Findings to Predict Risk of Recurrence in Pediatric Intussusception After Air Enema Reduction

Zhang, Yuan; Shao, Chunchun; Wei, Xiuliang; Ni, Pingjuan; Guan, Hui; Zhao, Chen; Li, Dianguo; Zhang, Fei-Xue

doi:10.1002/jum.15814

Cited by 5 publications

(5 citation statements)

References 33 publications

(81 reference statements)

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“…Our analysis also identified mesenteric lymph node enlargement as a predictor of in-hospital recurrence of intestinal intussusception (OR = 1.90). This result agrees with the study of Zhang et al, who found that enlarged abdominal lymph nodes were related to recurrence of intussusception [ 20 ]. Adhikari et al also observed that the incidence of lymph node enlargement was numerically higher in the recurrence group than in the non-recurrence group (61.5% vs. 47.7%), although the difference was not statistically significant [ 30 ].…”

Section: Discussionsupporting

confidence: 93%

“…For example, Guo et al found that symptom duration ≤ 12 h and mass located in the right abdomen were independent predictors of recurrent intussusception [ 13 ], whereas the factors identified by Xie et al included duration of symptoms ≥ 48 h and mass located in the left abdomen [ 16 ]. Furthermore, Zhang et al demonstrated that mass diameter > 2.55 cm and enlarged abdominal lymph nodes were related to recurrence of intussusception [ 20 ], whereas Vo et al did not identify any radiologic features that were associated with early recurrence, although the risk of recurrence was higher in females and patients with fever [ 17 ]. A recent meta-analysis by Ye et al identified only fever, absence of vomiting and PLPs as factors associated with a higher risk of recurrence of intestinal intussusception [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with in-hospital recurrence of intestinal intussusception in children

Zhang,

Dong,

et al. 2023

BMC Pediatr

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Background A minority of children experience in-hospital recurrence of intestinal intussusception after treatment. This study investigated the factors associated with in-hospital recurrence of intussusception in pediatric patients in China. Methods This retrospective study included patients aged 0–18 years-old with intestinal intussusception treated at Hainan Women and Children’s Medical Center between January 2019 and December 2019. Demographic and clinical characteristics were extracted from the medical records. Factors associated with in-hospital recurrence of intussusception were identified by logistic regression analysis. Results The analysis included 624 children (400 boys) with a median age of 1.8 years (range, 2 months and 6 days to 9 years). Seventy-three children (11.7%) had in-hospital recurrence of intussusception after successful reduction with air enema. Multivariate logistic regression analysis identified age > 1 year-old (odds ratio [OR]: 7.65; 95% confidence interval [95%CI]: 2.70–21.71; P < 0.001), secondary intestinal intussusception (OR: 14.40; 95%CI: 4.31–48.14; P < 0.001) and mesenteric lymph node enlargement (OR: 1.90; 95%CI: 1.13–3.18; P = 0.015) as factors independently associated with in-hospital recurrence of intussusception. Conclusions Age > 1 year-old, secondary intussusception and mesenteric lymph node enlargement were independently associated with increased odds of in-hospital recurrence of intussusception after successful reduction with air enema.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Factors associated with in-hospital recurrence of intestinal intussusception in children

Zhang,

Dong,

et al. 2023

BMC Pediatr

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“…Duc et al ( 21 ) found that surgical intussusception had a significantly smaller diameter than non-surgical intussusception. Zhang et al ( 22 ) reported that intussusception recurrence was prone with greater mass diameter. Consistent with previous studies, logistic regression analysis used in this study showed that long-axis diameter was identified as an independent predictor of surgical intervention for intussusception.…”

Section: Discussionmentioning

confidence: 99%

“…Other risk factors such as age, light weight (9, 25), temperature >37.8°C (9,22) and location of mass (9) were identified as independent predictors for non-surgical intussusception reduction failure in previous studies. However, in the present study, these factors did not show strong association with surgical intervention after hydrostatic reduction.…”

Section: Discussionmentioning

confidence: 99%

Developing a nomogram for predicting surgical intervention in pediatric intussusception after hydrostatic reduction

Wang

Xia

et al. 2023

Front. Pediatr.

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PurposeThe aim of this study was to develop and validate a nomogram for predicting surgical intervention in pediatric intussusception after hydrostatic reduction.MethodsChildren with intussusception who had treated with sonographically guided saline hydrostatic reduction as an initial treatment were enrolled in this study. The enrolled patients were randomly selected for training and validation sets, and the split ratio was 7:3. The medical records of enrolled patients were retrospectively reviewed. The patients were divided into a surgery and a non-surgery group according to the results of the nonsurgical reduction. A model for predicting the risk of surgical treatment was virtualized by the nomogram using logistic regression analysis.ResultsThe training set consisted of 139 patients and the validation set included 74. After logistic regression analysis using training set, duration of symptoms, bloody stools, white blood cells (WBCs), creatine kinase isoenzyme (CK-MB), long-axis diameter, poor prognostic signs by ultrasound and mental state were identified as the independent predictors of surgical intervention for intussusception. A model that incorporated the above independent predictors was developed and presented as a nomogram. The C-index of the nomogram in the validation set was 0.948 (95% CI, 0.888–1.000). The calibration curve demonstrated a good agreement between prediction and observation. The decision curve analysis (DCA) curve showed that the model achieved a net benefit across all threshold probabilities.ConclusionBased on the predictors of duration of symptoms, bloody stools, WBCs, CK-MB, long-axis diameter, poor prognostic signs by ultrasound and mental state, we developed a nomogram for predicting surgical intervention after hydrostatic reduction. This nomogram could be applied directly to facilitate pre-surgery decision for pediatric intussusception.

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“…Hence, it is extremely important and necessary to develop a simple and effective way of predicting recurrent intussusception. There have been several studies exploring the risk factors of recurrent intussusception such as age, duration of symptoms and absence of vomiting, [10][11][12] but they are still incomplete. Intestines play an important role in regulating systemic immune inflammation as the body's largest lymphoid organ.…”

Section: The Authors Have No Conflicts Of Interest To Disclosementioning

confidence: 99%

Th2/Th1 cytokine imbalance is associated with higher recurrent intussusception incidence in children: A 10-year retrospective study of 1657 patients

Li²,

Liu

et al. 2023

Medicine

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Recurrent intussusception is one of the common acute abdominal diseases in infants, which seriously affects the physical and mental health of infants, but its risk factors have not been fully clarified. The objective of this study was to evaluate the relationship between Th2/Th1 cytokine imbalance and recurrent intussusception, so as to provide a theoretical basis for making a more comprehensive treatment strategy for patients with recurrent intussusception. A retrospective study was conducted between July 2012 and September 2022, enrolling patients with intussusception in Children’s Hospital of Hebei Province. The patients were divided into recurrent group and non-recurrent group according to whether they suffered from recurrent intussusception. We summarized the clinical characteristics of recurrent intussusception and explored the role of T helper 2 (Th2)/T helper 1 (Th1) cytokine imbalance in it. A total of 2008 patients were initially enrolled and finally 1657 patients qualified for the study. The results showed that the incidence of recurrent intussusception was 18.41% and the Th2/Th1 cytokine imbalance was closely related to the incidence of recurrent intussusception. Th2/Th1 cytokine imbalance is a potential risk factor of recurrent intussusception and more likely to occur in children between the ages of 2 and 3. Future studies are needed to preemptively target the Th2/Th1 cytokine imbalance to formulate a reasonable treatment plan for children with intussusception to avoid recurrence.

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Ultrasound Findings to Predict Risk of Recurrence in Pediatric Intussusception After Air Enema Reduction

Cited by 5 publications

References 33 publications

Factors associated with in-hospital recurrence of intestinal intussusception in children

Factors associated with in-hospital recurrence of intestinal intussusception in children

Developing a nomogram for predicting surgical intervention in pediatric intussusception after hydrostatic reduction

Th2/Th1 cytokine imbalance is associated with higher recurrent intussusception incidence in children: A 10-year retrospective study of 1657 patients

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