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P192 Sonographic aspects in paediatric intussusception – self-limiting versus intervention requiring cases
  1. Bardi-Peti Luiza
  1. Department of Paediatrics, Regina Maria – The Private Healthcare Network, Bucharest, Romania
  2. Department of Paediatrics, ‘Dr. Victor Gomoiu’ Children’s Clinical Hospital, Bucharest, Romania

Abstract

Background and aims Intussusception is a process in which a proximal intestinal segment telescopes into the lumen of an adjacent distal segment, causing bowel obstruction. The purpose of this study was to determine whether there are sonographic findings that can be used to differentiate paediatric benign self-limited intussusception from cases that necessitate intervention.

Methods 14 cases of intussusception were identified by a retrospective search in children diagnosed by the author using ultrasonography during a 4 year period (2012–2016) at the paediatric emergency room of Regina Maria Baneasa Hospital. Sonographic findings (length of the invaginated segment, external bowel wall thickening, enlarged lymph nodes, peritoneal fluid) were correlated with follow-up data from the patient database and telephonic informations. Episodes were grouped as self-limited (group1) or cured by enema or surgery (group2) and compared using the Wilcoxon rank sum test.

Results The 14 cases of intussusception were diagnosed in 11 children with the mean age of 2.5 years (range: 5 months to 5 years and 9 months), 4 boys and 7 girls. 4 of them had recurrent episodes. The localisation was ileocolic(n=10), ileo-ileal(n=3), and colo-colic(n=1). As a possible leading cause, mesenteric lymph nodes were found in 6 cases, Rotavirus infection in proved 3 cases, all with spontaneous resolution, cow-milk protein intollerance proved in 2 chidren. Free peritoneal fluid was noted in 1 patient cured by contrast enema. 9 cases of intusussception had spontaneous resolution during the same examination or in the next hour. Contrast enemas were performed in 5 children, all with ileo-colic localization, with successful reduction in 3. 2 of them required surgery, but without bowel resection. The mean length of involved segment was 3,05 cm (range 1,8–3,8 cm) in self-limited cases and 4,12 cm (range 4–4,5 cm) in patients who required intervention, with a high statistical significance (p<0.01). The mean thickening of the external layer was 3,4 mm in group 1 (range 2,7–5 mm) and 4,6 mm in group 2 (range 4–5 mm), but without statistical significance.

Conclusions Benign self-limited intussusception was associated with a reduced length of the involved segment when compared with cases that necessitated intervention (p<0.01). The maximum length in self-limited cases was 3.8 cm in this study.

  • paediatric intussusception ultrasound

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