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Intramural and subserosal echogenic foci on US in large-bowel intussusceptions: prognostic indicator for reducibility?

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Abstract

Background

In large-bowel intussusceptions, several US signs are known to indicate a lower likelihood of reducibility by enema. US can demonstrate echogenic dots or lines (foci) in the bowel wall, which might indicate an ischemic bowel.

Objective

To determine the presence of echogenic intramural and subserosal foci in large-bowel intussusceptions and to evaluate the degree of correlation with reducibility.

Materials and methods

Between 2001 and 2008, 74 consecutive US examinations were retrospectively evaluated by two pediatric radiologists for intramural and subserosal echogenic foci, or trapped gas, in the intussusception. The degree of correlation between the sonographic findings and reducibility was evaluated.

Results

Of 73 intussusceptions examined by US, 56 (76%) were reducible and 17 (23%) were not reducible. Out of 10 intussusceptions with intramural gas, 11 with subserosal gas, and 14 with intramural and subserosal gas, 8 (80%), 6 (56%), 9 (64%), respectively, were not reducible. The presence of intramural gas or subserosal gas or both predicted a lower chance of reduction, but with regard to the effect of these findings together, intramural gas was the only significant predictor.

Conclusion

Having intramural gas in large-bowel intussusception significantly decreases the chance of reduction.

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References

  1. Bowerman RA, Silver TM, Jaffe MH (1982) Real-time ultrasound diagnosis of intussusception in children. Radiology 143:527–529

    PubMed  CAS  Google Scholar 

  2. Swischuk LE, Hayden CK, Boulden T (1985) Intussusception: indications for ultrasonography and an explanation of the doughnut and pseudokidney signs. Pediatr Radiol 15:388–391

    Article  PubMed  CAS  Google Scholar 

  3. del-Pozo G, Gonzalez-Spinola J, Gomez-Anson B et al (1996) Intussusception: trapped peritoneal fluid detected with US – relationship to reducibility and ischemia. Radiology 201:379–383

    PubMed  CAS  Google Scholar 

  4. Hanquinet S, Anooshiravani M, Vunda A et al (1998) Reliability of color Doppler and power Doppler sonography in the evaluation of intussuscepted bowel viability. Pediatr Surg Int 13:360–362

    Article  PubMed  CAS  Google Scholar 

  5. Koumanidou C, Vakaki M, Pitsoulakis G et al (2002) Sonographic detection of lymph nodes in the intussusception of infants and young children: clinical evaluation and hydrostatic reduction. AJR 178:445–450

    PubMed  CAS  Google Scholar 

  6. Berlin L (1998) Reducing the intussuscepted colon. AJR 170:1161–1163

    PubMed  CAS  Google Scholar 

  7. Daneman A, Navarro O (2004) Intussusception. Part 2: an update on the evolution of management. Pediatr Radiol 34:97–108

    Article  PubMed  Google Scholar 

  8. del-Pozo G, Albillos JC, Tejedor D et al (1999) Intussusception in children: current concepts in diagnosis and enema reduction. Radiographics 19:299–319

    PubMed  CAS  Google Scholar 

  9. Bloom RA, Craciun E, Lebensart PD et al (1992) The ultrasound appearances of intramural bowel gas: the bright ring appearance and the effervescent bowel. A report of three cases. Br J Radiol 65:585–588

    Article  PubMed  CAS  Google Scholar 

  10. Kim WY, Kim IO, Kim WS et al (2007) Sonographic findings in a model of ischemia-induced necrotizing enterocolitis with pathological correlations. Invest Radiol 42:312–318

    Article  PubMed  Google Scholar 

  11. Oktar SO, Yucel C, Erbas G et al (2006) Use of twinkling artifact in sonographic detection of intestinal pneumatosis. Abdom Imaging 31:293–296

    Article  PubMed  CAS  Google Scholar 

  12. Romano S, Lassandro F, Scaglione M et al (2006) Ischemia and infarction of the small bowel and colon: spectrum of imaging findings. Abdom Imaging 31:277–292

    Article  PubMed  CAS  Google Scholar 

  13. St Peter SD, Abbas MA, Kelly KA (2003) The spectrum of pneumatosis intestinalis. Arch Surg 138:68–75

    Article  PubMed  Google Scholar 

  14. Pracros JP, Tran-Minh VA, Morin de Finfe CH et al (1987) Acute intestinal intussusception in children. Contribution of ultrasonography (145 cases). Ann Radiol (Paris) 30:525–530

    CAS  Google Scholar 

  15. Verschelden P, Filiatrault D, Garel L et al (1992) Intussusception in children: reliability of US in diagnosis – a prospective study. Radiology 184:741–744

    PubMed  CAS  Google Scholar 

  16. Henrikson S, Blane CE, Koujok K et al (2003) The effect of screening sonography on the positive rate of enemas for intussusception. Pediatr Radiol 33:190–193

    PubMed  Google Scholar 

  17. Lim HK, Bae SH, Lee KH et al (1994) Assessment of reducibility of ileocolic intussusception in children: usefulness of color Doppler sonography. Radiology 191:781–785

    PubMed  CAS  Google Scholar 

  18. Faingold R, Daneman A, Tomlinson G et al (2005) Necrotizing enterocolitis: assessment of bowel viability with color Doppler US. Radiology 235:587–594

    Article  PubMed  Google Scholar 

  19. Wilson SR, Burns PN, Wilkinson LM et al (1999) Gas at abdominal US: appearance, relevance, and analysis of artifacts. Radiology 210:113–123

    PubMed  CAS  Google Scholar 

Download references

Acknowledgement

The project was supported by a grant from the National Center for Research Resources (no. UL1RR024986). The content is solely the responsibility of the authors and does not necessarily represent the official views of NCRR or the National Institutes of Health.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Inselspital Berne (University Hospital of Berne), CH-3010, Berne, Switzerland

    Enno Stranzinger

  2. Section of Pediatric Radiology, University of Michigan Health System, Ann Arbor, MI, USA

    Enno Stranzinger, Michael A. DiPietro, Sai Yarram & Peter J. Strouse

  3. Michigan Institute for Clinical and Health Research (MIHR), Ann Arbor, MI, USA

    Shokoufeh Khalatbari

Authors
  1. Enno Stranzinger
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  2. Michael A. DiPietro
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  3. Sai Yarram
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  4. Shokoufeh Khalatbari
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  5. Peter J. Strouse
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Correspondence to Enno Stranzinger.

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Stranzinger, E., DiPietro, M.A., Yarram, S. et al. Intramural and subserosal echogenic foci on US in large-bowel intussusceptions: prognostic indicator for reducibility?. Pediatr Radiol 39, 42–46 (2009). https://doi.org/10.1007/s00247-008-1039-y

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  • DOI: https://doi.org/10.1007/s00247-008-1039-y

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