title: Abdominal radiography is not necessary in children with intussusception.
abstract: BACKGROUND
  Children with intussusception require rapid and accurate diagnosis to enable timely intervention for satisfactory outcome. Ultrasonography is the recommended standard diagnostic modality; however, abdominal radiography (AR) is still used as an initial investigation. The aim of this study was to investigate the benefit of AR in intussusception by determining diagnostic accuracy and analysing correlation of AR findings with outcome.
  
  
  METHODS
  Index cases of intussusception presenting over 15 years (1998-2013) were analysed. Those who had AR performed were allocated into groups with positive or normal findings. Outcome of pneumatic reduction of intussusception (PRI) between these groups was compared.
  
  
  RESULTS
  Six hundred and forty-four cases of intussusception treated with PRI were identified, 412 (64 %) had AR performed and 232 (36 %) did not. 303 (74 %) radiographs had positive findings and 109 (26 %) were normal. The success rate of PRI did not differ between AR positive (82 %) and AR normal (84 %). Occult pneumoperitoneum was not detected in any patient by AR in our cohort.
  
  
  CONCLUSIONS
  AR is not recommended for the diagnosis of intussusception in children, for the prediction of the outcome of PRI or for the detection of occult pneumoperitoneum. AR should always be performed when clinical peritonism is present but is not otherwise necessary in children with suspected or confirmed intussusception.
authors.affiliation: Our Lady's Children's Hospital Crumlin, Dublin 12, Ireland.
authors.forename: Farhan
authors.initials: F
authors.lastname: Tareen
authors.affiliation: Our Lady's Children's Hospital Crumlin, Dublin 12, Ireland. danimclr@hotmail.com.|National Children's Research Centre, Gate 5, Our Lady's Children's Hospital Crumlin, Dublin 12, Ireland. danimclr@hotmail.com.
authors.forename: Danielle
authors.initials: D
authors.lastname: Mc Laughlin
authors.affiliation: Our Lady's Children's Hospital Crumlin, Dublin 12, Ireland.
authors.forename: Fiona
authors.initials: F
authors.lastname: Cianci
authors.affiliation: Children's University Hospital, Temple Street, Dublin 1, Ireland.
authors.forename: Siobhan M
authors.initials: SM
authors.lastname: Hoare
authors.affiliation: Our Lady's Children's Hospital Crumlin, Dublin 12, Ireland.
authors.forename: Brian
authors.initials: B
authors.lastname: Sweeney
authors.affiliation: Our Lady's Children's Hospital Crumlin, Dublin 12, Ireland.|Children's University Hospital, Temple Street, Dublin 1, Ireland.
authors.forename: Alan
authors.initials: A
authors.lastname: Mortell
authors.affiliation: National Children's Research Centre, Gate 5, Our Lady's Children's Hospital Crumlin, Dublin 12, Ireland.
authors.forename: Prem
authors.initials: P
authors.lastname: Puri
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007443:Intussusception / Q000175:diagnosis*; D008297:Male; D011860:Radiography, Abdominal; D015203:Reproducibility of Results; D012189:Retrospective Studies
keywords: Children; Intussusception; Outcome; Pneumoperitoneum; Radiography