Background Although ultrasound is often the preferred pediatric imaging study, many institutions lack ultrasound access at night for evaluation of intussusceptions in children. The purpose of this study was to characterize patterns of daytime and nighttime use of radiographic imaging for evaluation of intussusceptions.
Methods A retrospective chart review of patients evaluated for intussusceptions from January 2010 to December 2010 was performed to evaluate daytime and nighttime use of radiographic imaging for pediatric patients. Patients were further stratified by time of performance of imaging study into “day” and “night” categories. Differences in clinical characteristics, imaging study, cost, and final diagnosis between daytime and night were analyzed.
Results 86 pediatric consults with suspected intussusceptions were performed. Forty (46.5%) consults were performed during the day. During the day, 38 (95%) patients underwent US and 33 (82.5%) had abdominal films. At night, 3 (6.5%) CTs and 39 (84.7 %) abdominal films were performed. The positive rate of enemas during the daytime was significant statistically higher than at night (97.6% vs 59.2%, p<0.001). Average daytime cost of initial radiology evaluation was 1159 dollars compared with 3328 dollars at night (p<0.001). In terms of radiation dose, the daytime dose was significantly lower than the those at night (0.63±0.48 mSv vs 2.06± 1.48 mSv, p<0.001).
Conclusions Radiographic imaging at night results in higher average radiation exposure and cost. Twentyfour-hour ultrasound availability would decrease radiation exposure and cost of evaluation of children presenting with intussusceptions.