Accurately distinguishing pediatric ileocolic intussusception from small-bowel intussusception using ultrasonography
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In brief
In brief
Retrospective study of 183 pediatric intussusception cases demonstrates key ultrasonographic features to differentiate ileocolic from small-bowel intussusception, including lesion diameter, wall thickness, and presence of normal ileocecal anatomy. Systematic scanning of the ileocecal region and ascending colon significantly improves diagnostic accuracy and prevents misdiagnosis that could lead to inappropriate treatment.
Written by the GCMD Library team from the article.
Abstract
Purpose
The clinical treatment of ileocolic intussusception is different from that of small-bowel intussusception (SBI). This study aimed to analyze the differences between the two groups using ultrasonoscopy to avoid misdiagnosis.
Methods
We conducted a retrospective study of intussusception in patients aged 0–18 years from September 2018 to March 2020. Clinical and ultrasonoscopy data were reviewed.
Results
A total of 183 cases of intussusception were included in this study (123 cases of SBI and 60 of ileocolic intussusception). Ultrasonoscopy features that were significantly different between the two groups (p<0.05) included the lesion diameter, fat core thickness, outer wall thickness, lymph nodes inside intussusception, and lesion length. In the SBI group, 85% (104/123) of the normal ileocecal region was found in the right lower quadrant and 98% (120/123) of the normal ascending colon was found in the right side of the abdomen. In the ileocolic intussusception group, none of the normal ileocecal region was found and the ascending colon was found in only 5 cases (8%) (p<0.05).
Conclusions
The use of ultrasonography is the most practical method to distinguish SBI from ileocolic intussusception. In addition to comparing the differences between lesions, conventional probing of the ileocecal region and ascending colon will help to accurately differentiate between the types of intussusception and avoid misdiagnosis.
Levels of Evidence
Diagnostic.