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

Langenbecks Arch Surg. 2011 Oct;396(7):1035-40. doi: 10.1007/s00423-011-0742-6. Epub 2011 Jan 28.

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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cohort Studies
  • Confidence Intervals
  • Female
  • Follow-Up Studies
  • Humans
  • Ileal Diseases / diagnostic imaging*
  • Ileal Diseases / surgery
  • Ileal Diseases / therapy
  • Infant
  • Intestine, Small / diagnostic imaging
  • Intestine, Small / physiopathology
  • Intussusception / diagnostic imaging*
  • Intussusception / surgery*
  • Intussusception / therapy
  • Jejunal Diseases / diagnostic imaging*
  • Jejunal Diseases / surgery*
  • Jejunal Diseases / therapy
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Odds Ratio
  • Pediatrics
  • Postoperative Complications / epidemiology
  • Postoperative Complications / physiopathology
  • Predictive Value of Tests
  • ROC Curve
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Treatment Outcome
  • Ultrasonography, Doppler / methods