Pediatric Radiology

, Volume 22, Issue 2, pp 112–114 | Cite as

Value of sonography including color Doppler in the diagnosis and management of long standing intussusception

  • A. H. Lam
  • K. Firman
Originals

Abstract

15 cases of intussusception with presenting symptoms of more than 24 h duration were studied by sonography and Doppler. The aim of the study was to determine the validity of the sonographic criteria of peritonitis and bowel ischaemia in order to reduce the risk of colonic perforation and to increase confidence in achieving a successful hydrostatic reduction. The results were reviewed retrospectively and cases divided into 2 groups. Cases in group 1 were reducible by barium enema while those in group 2 required surgical intervention. Sonographic features of peritonitis were absent in all cases of group 1 and 3 cases of group 2. These 3 cases were reduced manually at surgery while the other 5 cases in group 2 with positive features of peritonitis required bowel resection. Blood flow was documented by colour flow Doppler in all cases except the 3 cases with gangrenous bowel in group 2. When sonographic features of peritonitis and loss of blood flow to the intussusception are present in late intussusception, surgical intervention is required. On the other hand, enema reduction should be pursued when such features are absent.

Keywords

Public Health Color Blood Flow Barium Perforation 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bettenay F, Beasley SW, de Campo JF (1988) Clinical prediction of outcome of barium reduction. Aust NZ J Surg 58:899–902Google Scholar
  2. 2.
    Boldt DW (1991) Intussusception. New look at old disease. Pediatric Imaging: Update '91, International Pediatric Radiology '91, p 105–118. Berns Congress, Stockholm, SwedenGoogle Scholar
  3. 3.
    Clubbe CPB (1907) The diagnosis and treatment of intussusception. Hodden and Stoughton, LondonGoogle Scholar
  4. 4.
    Fanconi S, Berger D, Rickham PP (1982) Acute intussusception: a classical picture? Helv Paediatr Acta 37:345PubMedGoogle Scholar
  5. 5.
    Ein SH (1976) The painless intussusception. J Paediatr Surg 11: 563Google Scholar
  6. 6.
    Jones PF (1987) Emergency abdominal surgery in infancy, childhood and adult life, 2nd edn. Blackwell, Oxford, p 26Google Scholar
  7. 7.
    Jones PG, Woodward AA (1989) Clinical paediatric surgery, 3rd edn. Blackwell, Oxford, p 243Google Scholar
  8. 8.
    Liu KW, McCarthy J, Guiney EJ (1986) Intussusception: current trends in management. Arch Dis Child 61:75PubMedGoogle Scholar
  9. 9.
    Rees BI, Lari J (1976) Chronic intussusception in children. Br J Surg 63:33PubMedGoogle Scholar
  10. 10.
    Swischuk LE, Stansberry SD (1991) Ultrasonographic detection of free peritoneal fluid in uncomplicated intussusception. Pediatr Radiol 21:350CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • A. H. Lam
    • 1
  • K. Firman
    • 1
  1. 1.Department of RadiologyRoyal Alexandra Hospital for ChildrenSydneyAustralia

Personalised recommendations