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. 2021 Mar;24(2):135-144.
doi: 10.5223/pghn.2021.24.2.135. Epub 2021 Mar 4.

Suspecting Intussusception and Recurrence Risk Stratification Using Clinical Data and Plain Abdominal Radiographs

Ye Rim Oh  1 , Bo Kyung Je  2 , Chaeyoun Oh  3 , Jae Hyung Cha  4 , Jee Hyun Lee  5
Affiliations

Suspecting Intussusception and Recurrence Risk Stratification Using Clinical Data and Plain Abdominal Radiographs

Ye Rim Oh et al. Pediatr Gastroenterol Hepatol Nutr. 2021 Mar.

Abstract

Purpose: Although ultrasonography is the gold standard of diagnosing intussusception, plain abdomen radiograph (AXR) is often used to make differential diagnosis for pediatric patients with abdominal pain. In intussusception patients, we aimed to analyze the AXR and clinical data to determine the characteristics of early AXR findings associated with diagnosis of intussusception and recurrence after reduction.

Methods: Between January 2011 and June 2018, 446 patients diagnosed with intussusception based on International Classification of Diseases-10 code of K56.1 were admitted. We retrospectively reviewed medical records of 398 patients who received air reduction; 51 of them have recurred after initial reduction. We evaluated six AXR features including absent ascending colon gas, absent transverse colon gas, target sign, meniscus sign, mass, and ileus. Clinical data and AXR features were compared between single episode and recurrence groups.

Results: Two groups did not show significant differences regarding clinical data. Mean time to recurrence from air reduction was 3.4±3.2 days. Absent ascending colon gas (63.9%) was the most common feature in intussusception, followed by mass (29.1%). All of six AXR features were observed more frequently in the recurrence group. Absent transverse colon gas was the most closely associated AXR finding for recurrence (odds ratio, 2.964; 95% confidence interval, 1.327-6.618; p=0.008).

Conclusion: In our study, absence of ascending colon gas was the most frequently seen AXR factor in intussusception patients. Extended and careful observation after reduction may be beneficial if such finding on AXR is found in intussusception patients.

Keywords: Abdominal radiographs; Intussusception; Pediatrics; Recurrence.

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Conflict of interest statement

Conflict of Interest: The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1. Flowchart for the selection of patients. Recurrence episode group: patients who experienced recurrence after initial reduction. Relapsed group: patients who have recurred after 14 days od initial treatment. Relapsed group was included in the recurrence episode group but was excluded in recurrence analysis.
AXR: abdomen radiograph.
See this image and copyright information in PMC

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