Skip to main content

Advertisement

SpringerLink
Log in

Sonographic findings predictive of the need for surgical management in pediatric patients with small bowel intussusceptions

  • Original Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Purpose

This study aims to evaluate ultrasound findings that are predictive of the need for surgical management in pediatric patients with small bowel intussusceptions (SBIs).

Methods

A retrospective review of pediatric patients with SBIs treated from 2004 to 2009 was conducted. Patients were divided into surgical and non-surgical groups. Demographic data, ultrasound findings, treatments, and outcomes were collected and analyzed.

Results

There were 56 cases of SBIs in 31 males and 25 females ranging in age from 4 months to 9 years; 39 patients were managed conservatively and 17 patients underwent surgery. The mean length and diameter of the intussusception in the surgical group were 6.53 and 2.78 cm, respectively, and 3.21 and 1.81 cm, respectively in the non-surgical group (both, P < 0.001). Multivariate logistic regression analysis indicated that diameter, length, and thickness of the outer rim were independent predictors of surgery. Receiver operating characteristic curve analysis indicated an intussusception diameter ≥2.1 cm, length ≥4.2 cm, and thickness of the outer rim ≥0.40 cm were optimal cutoff values for predicting the need for surgery.

Conclusions

A diameter ≥2.1 cm, length ≥4.2 cm, and thickness of the outer rim ≥0.40 cm predict the need for surgical management in pediatric patients with SBIs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Munden MM, Bruzzi JF, Coley BD, Munden RF (2007) Sonography of pediatric small-bowel intussusception: differentiating surgical from nonsurgical cases. AJR Am J Roentgenol 188:275–279

    Article  PubMed  Google Scholar 

  2. Ko SF, Lee TY, Ng SH, Wan YL, Chen MC, Tiao MM, Liang CD, Shieh CS, Chuang JH (2002) Small bowel intussusception in symptomatic pediatric patients: experiences with 19 surgically proven cases. World J Surg 26:438–443

    Article  PubMed  Google Scholar 

  3. Koh EP, Chua JH, Chui CH, Jacobsen AS (2006) A report of 6 children with small bowel intussusception that required surgical intervention. J Pediatr Surg 41:817–820

    Article  PubMed  Google Scholar 

  4. Kim JH (2004) US features of transient small bowel intussusception in pediatric patients. Korean J Radiol 5:178–184

    Article  PubMed  Google Scholar 

  5. Park NH, Park SI, Park CS (2007) Ultrasonographic findings of small bowel intussusception, focusing on differentiation from ileocolic intussusception. Br J Radiol 80:798–802

    Article  PubMed  CAS  Google Scholar 

  6. Tiao MM, Wan YL, Ng SH, Ko SF, Lee TY, Chen MC, Shieh CS, Chuang JH (2001) Sonographic features of small-bowel intussusception in pediatric patients. Acad Emerg Med 8:368–373

    Article  PubMed  CAS  Google Scholar 

  7. Kornecki A, Daneman A, Navarro O, Connolly B, Manson D, Alton DJ (2000) Spontaneous reduction of intussusception: clinical spectrum, management and outcome. Pediatr Radiol 30:58–63

    Article  PubMed  CAS  Google Scholar 

  8. Doi O, Aoyama K, Hutson JM (2004) Twenty-one cases of small bowel intussusception: the pathophysiology of idiopathic intussusception and the concept of benign small bowel intussusception. Pediatr Surg Int 20:140–143

    Article  PubMed  Google Scholar 

  9. Sönmez K, Turkyilmaz Z, Demirogullari B, Karabulut R, Aral YZ, Konuş O, Başaklar AC, Kale N (2002) Conservative treatment for small intestinal intussusception associated with Henoch–Schönlein's purpura. Surg Today 32:1031–1034

    Article  PubMed  Google Scholar 

  10. Wiersma F, Allema JH, Holscher HC (2006) Ileoileal intussusception in children: ultrasonographic differentiation from ileocolic intussusception. Pediatr Radiol 36:1177–1181

    Article  PubMed  Google Scholar 

  11. Mateen MA, Saleem S, Rao PC, Gangadhar V, Reddy DN (2006) Transient small bowel intussusceptions: ultrasound findings and clinical significance. Abdom Imag 31:410–416

    Article  CAS  Google Scholar 

  12. Strouse PJ, DiPietro MA, Saez F (2003) Transient small-bowel intussusception in children on CT. Pediatr Radiol 33:316–320

    PubMed  Google Scholar 

  13. Navarro O, Dugougeat F, Kornecki A, Shuckett B, Alton DJ, Daneman A (2000) The impact of imaging in the management of intussusception owing to pathologic lead points in children. A review of 43 cases. Pediatr Radiol 30:594–603

    Article  PubMed  CAS  Google Scholar 

  14. Mirilas P, Koumanidou C, Vakaki M, Skandalakis P, Antypas S, Kakavakis K (2001) Sonographic features indicative of hydrostatic reducibility of intestinal intussusception in infancy and early childhood. Eur Radiol 11:2576–2580

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This work was financially supported by Shengjing Outstanding Scientific Foundation (grant no. m850) from The Shengjing Hospital of China Medical University.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Ultrasound, Shengjing Hospital, China Medical University, Shenyang, 110004, China

    Yao Zhang, Shi-Xing Li, Shou-Jun Liu & Wei-Dong Ren

  2. Department of Pediatric Surgery, Shengjing Hospital of China Medical University, No. 36 Sanhao St, , Heping District, Shenyang, 110004, China

    Yu-Zuo Bai

  3. Department of Library, Shengjing Hospital of China Medical University, Shenyang, 110004, China

    Li-Qiang Zheng

Authors
  1. Yao Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yu-Zuo Bai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shi-Xing Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shou-Jun Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wei-Dong Ren
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Li-Qiang Zheng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yu-Zuo Bai.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhang, Y., Bai, YZ., Li, SX. et al. Sonographic findings predictive of the need for surgical management in pediatric patients with small bowel intussusceptions. Langenbecks Arch Surg 396, 1035–1040 (2011). https://doi.org/10.1007/s00423-011-0742-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-011-0742-6

Keywords

Search

Navigation