Intussusception in childhood: role of sonography on diagnosis and treatment.
OBJECTIVE
The aim of this study was to determine the role of ultrasound in the diagnosis and treatment of pediatric patients with acute abdominal pain caused by intussusceptions.


METHODS
We performed a retrospective study of all pediatric patients with acute abdominal pain caused by intussusceptions and that underwent ultrasound examination at the emergency service of the Radiology Department between November 2007 and June 2013. The role of ultrasonography in the diagnosis of intussusceptions has been assessed by comparing the echographic presumptive diagnosis with the final diagnosis of discharge. Its importance in the treatment has been assessed by determining the value of ultrasound findings in the choice of the best treatment.


RESULTS
The ultrasound examination was positive in 16/18 patients with a final diagnosis of intussusception. Some sonographic findings seemed to be able to predict the opportunity to resort to non-surgical therapeutic options like hydrostatic or pneumatic reduction of the intestinal segments invaginated. In our casuistry, five children presented characteristics typical of this subgroup and underwent barium enema which provided the reduction of the intestinal segments involved. The future challenge will be to perform non-surgical ultrasound-guided reductions to avoid the exposure of the infants to ionizing radiations.


CONCLUSIONS
Ultrasonography is essential not only in the diagnosis, but also it adds important elements in the therapeutic choice and could play in the future an important role in non-surgical reduction of intestinal intussusceptions in pediatric patients.
Department of Radiological Sciences, Radiology Institute, Catholic University of Rome, A. Gemelli Hospital. L.go A. Gemelli 8, 00168 Rome, Italy ; Via Monte Nagni n°5, 06034 Foligno (PG), Italy.
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M
Bartocci
Department of Radiological Sciences, Radiology Institute, Catholic University of Rome, A. Gemelli Hospital. L.go A. Gemelli 8, 00168 Rome, Italy.
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G
Fabrizi
Department of Radiological Sciences, Radiology Institute, Catholic University of Rome, A. Gemelli Hospital. L.go A. Gemelli 8, 00168 Rome, Italy.
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I
Valente
Department of Surgical Sciences, Pediatric Surgery Institute, Catholic University of Rome, A. Gemelli Hospital. L.go A. Gemelli 8, 00168 Rome, Italy.
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C
Manzoni
Department of Radiological Sciences, Radiology Institute, Catholic University of Rome, A. Gemelli Hospital. L.go A. Gemelli 8, 00168 Rome, Italy.
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S
Speca
Department of Radiological Sciences, Radiology Institute, Catholic University of Rome, A. Gemelli Hospital. L.go A. Gemelli 8, 00168 Rome, Italy.
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L
Bonomo
Childhood; Intussusception; Sonography