Transient small-bowel intussusception in children on CT

To determine the frequency and significance of small-bowel intussusception identified in children on CT. All abdomen CT reports between July 1995 and April 2002 were reviewed to identify patients with small-bowel intussusception. Intussusceptions were identified as an intraluminal mass with a charac...

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Bibliographic Details
Published in:Pediatric radiology 2003-05, Vol.33 (5), p.316-320
Main Authors: STROUSE, Peter J, DIPIETRO, Michael A, SAEZ, Fermin
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
Child
Child, Preschool
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Intestine, Small - diagnostic imaging
Intussusception - diagnostic imaging
Male
Medical sciences
Other diseases. Semiology
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Tomography, X-Ray Computed
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Summary:To determine the frequency and significance of small-bowel intussusception identified in children on CT. All abdomen CT reports between July 1995 and April 2002 were reviewed to identify patients with small-bowel intussusception. Intussusceptions were identified as an intraluminal mass with a characteristic layered appearance and/or continuity with adjacent mesenteric fat. Ileocolic intussusceptions and intussusceptions related to feeding tubes were excluded. Imaging studies and medical records were reviewed. Twenty-five pediatric patients (16 boys, 9 girls; mean age 11.2 years) were identified with small-bowel intussusception on CT. No patient had a persistent intussusception requiring surgery. Fourteen had limited immediate repeat CT images as part of the same examination, ten of which demonstrated resolution of the CT abnormality. Follow-up CT [ n=13 (6 within 24 h)], ultrasound ( n=3), small-bowel follow-through ( n=4) and surgery ( n=3) showed no intussusception. In four patients with persistent symptoms, underlying pathology was identified requiring treatment (giardiasis, 2; small-bowel inflammation/strictures, 1; abscess and partial small-bowel obstruction after perforated appendicitis, 1). In 21 other patients, direct correlation of symptoms to CT abnormality was absent or questionable, no treatment was required, and there was no clinical or imaging evidence of persistence or recurrence. Most small-bowel intussusceptions identified in children by CT are transient and of no clinical significance.
ISSN:0301-0449
1432-1998
DOI:10.1007/s00247-003-0870-4