Published online Jul 26, 2023. doi: 10.12998/wjcc.v11.i21.5014
Peer-review started: March 16, 2023
First decision: June 12, 2023
Revised: June 18, 2023
Accepted: June 27, 2023
Article in press: June 27, 2023
Published online: July 26, 2023
Intussusception is a primary cause of intestinal obstruction in young children. Delayed diagnosis is associated with increased morbidity. Ultrasonography (USG) is the gold standard for diagnosis, but it is operator dependent and often unavai
To study the clinical characteristics of intussusception including management and evaluation of the diagnostic accuracy of abdominal radiography (AR) and the promising parameters found in the pediatric intussusception score (PIS).
Children with suspected intussusception in our center from 2006 to 2018 were recruited. Clinical manifestations, investigations, and treatment outcomes were recorded. AR images were interpreted by a pediatric radiologist. Diagnosis of intussusception was composed of compatible USG and response with reduction. The diagnostic value of the proposed PIS was evaluated.
Ninety-seven children were diagnosed with intussusception (2.06 ± 2.67 years, 62.9% male), of whom 74% were < 2 years old and 37.1% were referrals. The common manifestations of intussusception were irritability or abdominal pain (86.7%) and vomiting (59.2%). Children aged 6 mo to 2 years, pallor, palpable abdominal mass, and positive AR were the parameters that could discriminate intussusception from other mimics (P < 0.05). Referral case was the only significant parameter for failure to reduce intussusception (P < 0.05). AR to diagnose intussusception had a sensitivity of 59.2%. The proposed PIS, a combination of clinical irritability or abdominal pain, children aged 6 mo to 2 years, and compatible AR, had a sensitivity of 85.7%.
AR alone provides poor screening for intussusception. The proposed PIS in combination with common manifestations and AR data was shown to increase the diagnostic sensitivity, leading to timely clinical management.
Core Tip: Intussusception is the most common cause of intestinal obstruction in young children. Early diagnosis and prompt management can lead to favorable outcomes. Ultrasonography is considered the gold standard for diagnosis, while abdominal radiography is typically used as the initial imaging study in suspicious cases. The present study found that AR had a sensitivity of 59.2%, but the sensitivity increased to 85.7% when in combination with data on clinical irritability, abdominal pain, and age. Pediatric intussusception score might be a helpful tool for general physicians or pediatricians in limited resource settings for early diagnosis and timely referral to increase favorable outcomes.