[Ultrasound in suspected intussusception].
Intussusception is one of the main abdominal emergencies in children. Accuracy of clinical diagnosis is poor and in only 30-40% of cases is the clinical diagnosis of intussusception confirmed. Many unnecessary barium enemas are performed due to clinical misdiagnosis. Sonography can demonstrate intussusception, is widely available, easily performed, does not produce radiation and can be used to screen suspected cases. From 1991-1993, in 6 of 14 consecutive cases of clinically suspected intussusception the ultrasound examination was positive. In 4 of them barium enema revealed intussusception, which was reduced by the barium enema procedure. A child was sent for surgery because ultrasonography showed a duplication cyst which was considered the leading point for the bowel invagination. In the last case surgery for bowel obstruction revealed impacted stool misdiagnosed by ultrasound as an intussusception mass. In all the 8 cases in which ultrasound was negative, follow-up confirmed the absence of intussusception. The sensitivity of the ultrasound examination was 100% and the negative predictive value 100%. These results are not in accord with those of other authors. We find ultrasound a reliable imaging modality for the diagnosis of intussusception. It can identify leading points as well as other causes for the clinical presentation, including ovarian torsion or appendicitis.
Ultrasound Unit, Carmel Medical Center, Haifa.
M
M
Barzilai
D001466:Barium Sulfate; D002648:Child; D003951:Diagnostic Errors; D004733:Enema; D006801:Humans; D007443:Intussusception / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014463:Ultrasonography
D001466:Barium Sulfate