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Published in: European Radiology 12/2016

01-12-2016 | Gastrointestinal

Clinical and Ultrasonographic Features of Secondary Intussusception in Children

Authors: Yao Zhang, Qian Dong, Shi-Xing Li, Wei-Dong Ren, Bo Shi, Yu-Zuo Bai, Shu-Cheng Zhang, Li-qiang Zheng

Published in: European Radiology | Issue 12/2016

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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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Literature
1.
go back to reference van Heurn LW, Pakarinen MP, Wester T (2014) Contemporary management of abdominal surgical emergencies in infants and children. Br J Surg 101:e24–e33CrossRefPubMed van Heurn LW, Pakarinen MP, Wester T (2014) Contemporary management of abdominal surgical emergencies in infants and children. Br J Surg 101:e24–e33CrossRefPubMed
2.
go back to reference Navarro OM, Daneman A, Chae A (2004) Intussusception: the use of delayed, repeated reduction attempts and the management of intussusceptions due to pathologic lead points in pediatric patients. AJR Am J Roentgenol 182:1169–1176CrossRefPubMed Navarro OM, Daneman A, Chae A (2004) Intussusception: the use of delayed, repeated reduction attempts and the management of intussusceptions due to pathologic lead points in pediatric patients. AJR Am J Roentgenol 182:1169–1176CrossRefPubMed
3.
go back to reference Zhang Y, Bai YZ, Li SX, Liu SJ, Ren WD, Zheng LQ (2011) Sonographic findings predictive of the need for surgical management in pediatric patients with small bowel intussusceptions. Langenbeck’s Arch Surg / Deutsche Gesellschaft fur Chirurgie 396:1035–1040CrossRef Zhang Y, Bai YZ, Li SX, Liu SJ, Ren WD, Zheng LQ (2011) Sonographic findings predictive of the need for surgical management in pediatric patients with small bowel intussusceptions. Langenbeck’s Arch Surg / Deutsche Gesellschaft fur Chirurgie 396:1035–1040CrossRef
4.
5.
go back to reference Gurses B, Kabakci N, Akyuz U, Pata C, Taviloglu K, Kovanlikaya I (2008) Imaging features of a cecal lipoma as a lead point for colo-colonic intussusception. Emerg Radiol 15:133–136CrossRefPubMed Gurses B, Kabakci N, Akyuz U, Pata C, Taviloglu K, Kovanlikaya I (2008) Imaging features of a cecal lipoma as a lead point for colo-colonic intussusception. Emerg Radiol 15:133–136CrossRefPubMed
6.
go back to reference Morrison J, Jeanmonod R (2011) Intussusception Secondary to a Meckel's Diverticulum in an Adolescent. Case reports in emergency medicine 2011:623863 Morrison J, Jeanmonod R (2011) Intussusception Secondary to a Meckel's Diverticulum in an Adolescent. Case reports in emergency medicine 2011:623863
7.
go back to reference Elemen L, Oz F, Erdogan E (2009) Heterotopic gastric mucosa leading to recurrent intussusceptions: report of a case. Surg Today 39:444–447CrossRefPubMed Elemen L, Oz F, Erdogan E (2009) Heterotopic gastric mucosa leading to recurrent intussusceptions: report of a case. Surg Today 39:444–447CrossRefPubMed
9.
go back to reference Blakelock RT, Beasley SW (1998) The clinical implications of non-idiopathic intussusception. Pediatr Surg Int 14:163–167CrossRefPubMed Blakelock RT, Beasley SW (1998) The clinical implications of non-idiopathic intussusception. Pediatr Surg Int 14:163–167CrossRefPubMed
10.
go back to reference He N, Zhang S, Ye X, Zhu X, Zhao Z, Sui X (2014) Risk factors associated with failed sonographically guided saline hydrostatic intussusception reduction in children. J Ultrasound Med : Off J Am Inst Ultrasound Med 33:1669–1675CrossRef He N, Zhang S, Ye X, Zhu X, Zhao Z, Sui X (2014) Risk factors associated with failed sonographically guided saline hydrostatic intussusception reduction in children. J Ultrasound Med : Off J Am Inst Ultrasound Med 33:1669–1675CrossRef
11.
go back to reference Daneman A, Alton DJ, Lobo E, Gravett J, Kim P, Ein SH (1998) Patterns of recurrence of intussusception in children: a 17-year review. Pediatr Radiol 28:913–919CrossRefPubMed Daneman A, Alton DJ, Lobo E, Gravett J, Kim P, Ein SH (1998) Patterns of recurrence of intussusception in children: a 17-year review. Pediatr Radiol 28:913–919CrossRefPubMed
12.
go back to reference Baldisserotto M, Spolidoro JV, Bahu Mda G (2002) Graded compression sonography of the colon in the diagnosis of polyps in pediatric patients. AJR Am J Roentgenol 179:201–205CrossRefPubMed Baldisserotto M, Spolidoro JV, Bahu Mda G (2002) Graded compression sonography of the colon in the diagnosis of polyps in pediatric patients. AJR Am J Roentgenol 179:201–205CrossRefPubMed
13.
go back to reference Chaubal N, Shah M, Dighe M, Ketkar D, Joshi A (2002) Juvenile polyposis of the colon: sonographic diagnosis. J Ultrasound Med : Off J Am Inst Ultrasound Med 21:1311–1314 Chaubal N, Shah M, Dighe M, Ketkar D, Joshi A (2002) Juvenile polyposis of the colon: sonographic diagnosis. J Ultrasound Med : Off J Am Inst Ultrasound Med 21:1311–1314
14.
go back to reference Parra DA, Navarro OM (2008) Sonographic diagnosis of intestinal polyps in children. Pediatr Radiol 38:680–684CrossRefPubMed Parra DA, Navarro OM (2008) Sonographic diagnosis of intestinal polyps in children. Pediatr Radiol 38:680–684CrossRefPubMed
15.
go back to reference Zhang Y, Li SX, Xie LM et al (2012) Sonographic diagnosis of juvenile polyps in children. Ultrasound Med Biol 38:1529–1533CrossRefPubMed Zhang Y, Li SX, Xie LM et al (2012) Sonographic diagnosis of juvenile polyps in children. Ultrasound Med Biol 38:1529–1533CrossRefPubMed
16.
go back to reference Satya R, O'Malley JP (2005) Case 86: Meckel diverticulum with massive bleeding. Radiology 236:836–840CrossRefPubMed Satya R, O'Malley JP (2005) Case 86: Meckel diverticulum with massive bleeding. Radiology 236:836–840CrossRefPubMed
17.
go back to reference Grosfeld JL (2005) Intussusception then and now: a historical vignette. J Am Coll Surg 201:830–833CrossRefPubMed Grosfeld JL (2005) Intussusception then and now: a historical vignette. J Am Coll Surg 201:830–833CrossRefPubMed
19.
go back to reference St-Vil D, Brandt ML, Panic S, Bensoussan AL, Blanchard H (1991) Meckel's diverticulum in children: a 20-year review. J Pediatr Surg 26:1289–1292CrossRefPubMed St-Vil D, Brandt ML, Panic S, Bensoussan AL, Blanchard H (1991) Meckel's diverticulum in children: a 20-year review. J Pediatr Surg 26:1289–1292CrossRefPubMed
20.
go back to reference Pepper VK, Stanfill AB, Pearl RH (2012) Diagnosis and management of pediatric appendicitis, intussusception, and Meckel diverticulum. Surg Clin N Am 92(505-526):vii Pepper VK, Stanfill AB, Pearl RH (2012) Diagnosis and management of pediatric appendicitis, intussusception, and Meckel diverticulum. Surg Clin N Am 92(505-526):vii
21.
go back to reference Blakeborough A, McWilliams RG, Raja U, Robinson PJ, Reynolds JV, Chapman AH (1997) Pseudolipoma of inverted Meckel's diverticulum: clinical, radiological and pathological correlation. Eur Radiol 7:900–904CrossRefPubMed Blakeborough A, McWilliams RG, Raja U, Robinson PJ, Reynolds JV, Chapman AH (1997) Pseudolipoma of inverted Meckel's diverticulum: clinical, radiological and pathological correlation. Eur Radiol 7:900–904CrossRefPubMed
22.
go back to reference Frances M, Lane AE, Lenard ZM (2013) Sonographic features of gastrointestinal lymphoma in 15 dogs. J Small Anim Pract 54:468–474CrossRefPubMed Frances M, Lane AE, Lenard ZM (2013) Sonographic features of gastrointestinal lymphoma in 15 dogs. J Small Anim Pract 54:468–474CrossRefPubMed
23.
go back to reference Fatima A, Gibson DP (2014) Pneumatosis intestinalis associated with Henoch-Schonlein purpura. Pediatrics 134:e880–e883CrossRefPubMed Fatima A, Gibson DP (2014) Pneumatosis intestinalis associated with Henoch-Schonlein purpura. Pediatrics 134:e880–e883CrossRefPubMed
Metadata
Title
Clinical and Ultrasonographic Features of Secondary Intussusception in Children
Authors
Yao Zhang
Qian Dong
Shi-Xing Li
Wei-Dong Ren
Bo Shi
Yu-Zuo Bai
Shu-Cheng Zhang
Li-qiang Zheng
Publication date
01-12-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 12/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4299-1

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