Computed Tomography Findings of Unanticipated Prolonged Ileocolic Intussusception in Children

Computed Tomography Findings of Unanticipated Prolonged Ileocolic Intussusception in Children

 

Devin Puapong, MD; Steven L Lee, MD, FACS, FAAP; Gary Radner, MD; Peter I Tsai, MD; Douglas S Katz, MD; Maher A Abbas, MD, FACS, FASCRS; Harry Applebaum, MD

Summer 2008 - Volume 12 Number 3

https://doi.org/10.7812/TPP/08-003

Abstract

Background: Attempted nonsurgical reduction of ileocolic intussusceptions after 48 hours is controversial because of the low probability of reduction and an increased risk of perforation. We sought to retrospectively identify computed tomography (CT) criteria that may help to predict bowel viability and successful enema reduction in children with ileocolic intussusception.

Methods: Unanticipated intussusception was diagnosed using CT in six children with mild, atypical symptoms of four to seven days' duration at a single institution during a one-year period. All patients underwent laparotomy without prior contrast enema. Surgical findings were compared with preoperative CT scan findings to identify any criteria that may predict successful nonsurgical management.

Results: Contrast CT scan findings were diagnostic of ileocolic intussusception. At the time of laparotomy, three children had easily reducible ileocolic intussusception with nonischemic bowel. Two children had irreducible intussusception with ischemic bowel requiring resection, and one child had a difficult reduction of nonischemic but edematous bowel. Preoperative CT scan findings correlated well with intraoperative findings for all patients. Findings of bowel-wall edema of the intussuscipiens and partial small-bowel obstruction shown on CT were associated with intussusception that was nonreducible or difficult to reduce.

Conclusion: Patients with prolonged intussusception diagnosed using CT scan may safely undergo contrast enema reduction if no bowel-wall edema of the intussuscipiens or obstruction is demonstrated.

 

TPJ20Years

 

The Permanente Journal is celebrating it's 20th anniversary year. We look forward to continuing to bring you more high-quality content during the next 20 years.

Subscriptions

Sponsored by the National Permanente Medical Groups, The Permanente Press publishes The Permanente Journal and books related to Kaiser Permanente and health care.

Circulation

25,000 print readers per quarter, 7,628 eTOC readers, and in 2016, 1.4 million page views on TPJ articles in PubMed from a broad international readership.

Letters

Articles, editorials, letters to the editor, and other material represent the opinion of the authors. Send your comments to permanente.journal@kp.org.


Copyright 2017 The Permanente Journal - Kaiser Permanente. All Rights Reserved.