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Clinical and Ultrasonographic Features of Secondary Intussusception in Children

  • Gastrointestinal
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Abstract

Objectives

The aim of this study was to review the ultrasonographic features of secondary intussusception (SI) in children and assess the value of ultrasound in the diagnosis of pediatric SI.

Methods

The authors performed a retrospective analysis on the ultrasound findings of 1977 cases of primary intussusception (PI) and 37 cases of SI in children. The SI cases were diagnosed by ultrasonography and confirmed by laparotomy or histopathologic diagnosis. The clinical and ultrasonographic features were analyzed and compared between these two groups.

Results

The age, no flatus or defecation, position, diameter and length of intussusception, the presence of free intraperitoneal liquid, and intestinal dialation at the proximal end present, all contributed to the differentiation between PI and SI (all P < 0.05). Ultrasound was able to demonstrate the pathological lead point (PLP) shadows in all of the 37 SI cases, either in the cervical part or intussusceptum of the intussusception. Among the 37 SI patients, 21 cases (56.8 %) were accurately categorized with lesions, including intestinal polyps, cystic intestinal duplication, intestinal wall lymphoma, and a small part of Meckel's diverticulum.

Conclusions

Ultrasound can be used as a feasible and effective method to discriminate PI from SI. Once the PLP is detected, a definite diagnosis can be made.

Key Points

• The clinical and ultrasonographic features were compared between SI and PI.

• The age, location, diameter and length of intussusception, and intestinal dilation were distinguishing features.

• The causes of SI were found to be polyps, intestinal duplication, lymphoma, and Meckel's diverticulum.

• Ultrasound can be used as an important method to diagnose SI.

• Demonstration and confirmation of PLP are vital to diagnosing SI.

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Abbreviations

SI:

Secondary intussusception

PI:

Primary intussusception

PLP:

Pathological lead point

CDFI:

Color Doppler Flow Imaging

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Acknowledgments

The scientific guarantor of this publication is Yu-Zuo Bai. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work was supported by the Outstanding Scientific Fund of Shengjing Hospital (grant No. m850). One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. The present study was approved by the Institutional Ethical Board of the hospital, and the requirement of informed consent was waived because of the retrospective study design. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Ultrasound, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang, 110004, People’s Republic of China

    Yao Zhang, Shi-Xing Li, Wei-Dong Ren, Bo Shi & Yu-Zuo Bai

  2. Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 110004, People’s Republic of China

    Qian Dong

  3. Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, 110004, People’s Republic of China

    Yu-Zuo Bai & Shu-Cheng Zhang

  4. Library, Shengjing Hospital of China Medical University, Shenyang, 110004, People’s Republic of China

    Li-qiang Zheng

Authors
  1. Yao Zhang
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  2. Qian Dong
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  3. Shi-Xing Li
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  4. Wei-Dong Ren
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  5. Bo Shi
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  6. Yu-Zuo Bai
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  7. Shu-Cheng Zhang
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Corresponding author

Correspondence to Yu-Zuo Bai.

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Fig. S1

The ultrasonic examination of a two-year-old boy shows an intussusception in the right upper abdomen, as well as multiple enlarged lymph nodes inside the intussusception. Ileocolic intussusception was diagnosed and successfully reduced by enema. (a) Ultrasound shows the “concentric circle” sign on cross-section and the diameter of the abdominal mass was 2.7 cm. (b) Ultrasound shows the “sleeve” sign on longitudinal section and the length of the mass was 5.7 cm (TIF 25501 kb)

High resolution image (GIF 118 kb)

Table S1

The ultrasonic characteristics of the 37 patients with secondary intussusception (DOC 36 kb)

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Zhang, Y., Dong, Q., Li, SX. et al. Clinical and Ultrasonographic Features of Secondary Intussusception in Children. Eur Radiol 26, 4329–4338 (2016). https://doi.org/10.1007/s00330-016-4299-1

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  • DOI: https://doi.org/10.1007/s00330-016-4299-1

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