CLINICO-RADIOLOGICAL FEATURES IN CORROBORATION WITH INTRAOPERATIVE FINDINGS OF INTUSSUSCEPTION IN INFANTS-LESSONS LEARNED FROM CASES SERIES IN REMOTE SET UP DURING OVERSEAS DEPLOYMENT (EAST AFRICA)

Authors

  • NARENDER YADAV Department of Radio-Diagnosis, AFMS, New Delhi, India.
  • RAVISHEKAR N HIREMATH Department of Community Medicine, AFMS, New Delhi, India.
  • PEEYUSH DHAGAT Department of Radio-Diagnosis, AFMS, New Delhi, India.
  • KASUKURTHI LEELAKANTH Department of Radio-Diagnosis, AFMS, New Delhi, India.
  • RISHI RAJ Department of Medical Informatics, AFMS, New Delhi, India.

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i5.46713

Keywords:

Intussusception infants clinical, Radiological.

Abstract

The incidence rate of Intussusception is higher in some developing countries, which leads to a higher rate of complications in those areas especially in children. Plain abdomen radiograph is the initial radiological examination to be done in a case of acute abdomen in a peripheral set up. Ultrasound (USG) would be best modality for initial screening even in remote areas as it has the advantages of being non-invasive, rapid, and not only cost effective but also avoids radiation exposure and easily available even in peripheral set up in today’s era. Moreover, can be done bedside, even with less experienced readers. Here, in this case series, we are discussing the clinic-radiological and intraoperative features of in intussusception in infants, while we were deployed in remote areas of Eastern Africa with limited settings. This article highlights the importance of strong clinical suspicion and timely ultrasonographic evaluation as primary screening modality in suspected cases of intussusception. USG not only confirms the diagnosis with classical signs and appearances but also help rule out other conditions mimicking the diagnosis and will decrease the risk for bowel obstruction, perforation, necrosis, and death by aiding in timely surgical intervention. In addition to this, the lesson learned from this case series is that, assessment of length of segment of bowel telescoping into the other segment will aid in deciding mode of surgical intervention.

Downloads

Download data is not yet available.

References

Walsh D. Intussusception. Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Available from: https://www.sages. org/wiki/intussusception [Last accessed on 2022 Mar 01].

Williams H. Imaging and intussusception. Arch Dis Child Educ Pract Ed 2008;93:30-6. doi: 10.1136/adc.2007.134304, PMID 18208983

Waseem M, Rosenberg HK. Intussusception. Pediatr Emerg Care 2008;24:793-800. doi: 10.1097/PEC.0b013e31818c2a3e, PMID 19018227

Tareen F, Mc Laughlin D, Cianci F, Hoare SM, Sweeney B, Mortell A, et al. Abdominal radiography is not necessary in children with intussusception. Pediatr Surg Int 2016;32:89-92. doi: 10.1007/s00383- 015-3817-6, PMID 26546340

Vujović D, Lukac M, Sretenović A, Krstajić T, Ljubić V, Antunović SS. Indications for repeated enema reduction of intussusception in children. Srp Arh Celok Lek 2014;142:320-4. doi: 10.2298/sarh1406320v, PMID 25033588

Daneman A, Alton DJ. Intussusception. Issues and controversies related to diagnosis and reduction. Radiol Clin North Am 1996;34:743-56. doi:10.1016/S0033-8389(22)00506-1, PMID 8677307

Applegate KE. Clinically suspected intussusception in children: Evidence-based review and self-assessment module. AJR Am J Roentgenol 2005;185 Suppl: S175-83. doi: 10.2214/ajr.185.3_ supplement.0185s175, PMID 16120899

Sorantin E, Lindbichler F. Management of intussusception. Eur Radiol 2004;14 Suppl 4:L146-54. doi: 10.1007/s00330-003-2033-2, PMID 14752570

Justice FA, Auldist AW, Bines JE. Intussusception: Trends in clinical presentation and management. J Gastroenterol Hepatol 2006;21:842-6. doi: 10.1111/j.1440-1746.2005.04031.x, PMID 16704533

Fiegel H, Gfroerer S, Rolle U. Systematic review shows that pathological lead points are important and frequent in intussusception and are not limited to infants. Acta Paediatr 2016;105:1275-9. doi: 10.1111/apa.13567, PMID 27588829

Lehnert T, Sorge I, Till H, Rolle U. Intussusception in children-- clinical presentation, diagnosis and management. Int J Colorectal Dis 2009;24:1187-92. doi: 10.1007/s00384-009-0730-2, PMID 19418060

Justice FA, de Campo M, Liem NT, Son TN, Ninh TP, Bines JE. Accuracy of ultrasonography for the diagnosis of intussusception in infants in Vietnam. Pediatr Radiol 2007;37:195-9. doi: 10.1007/ s00247-006-0381-1, PMID 17180657

Harrington L, Connolly B, Hu X, Wesson DE, Babyn P, Schuh S. Ultrasonographic and clinical predictors of intussusception. J Pediatr 1998;132:836-9. doi: 10.1016/s0022-3476(98)70314-2, PMID 9602196

Bartocci M, Fabrizi G, Valente I, Manzoni C, Speca S, Bonomo L. Intussusception in childhood: Role of sonography on diagnosis and treatment. J Ultrasound 2015;18:205-11. doi: 10.1007/s40477-014- 0110-9, PMID 26261462

Lee JY, Kim JH, Choi SJ, Lee JS, Ryu JM. Point-of-care ultrasound may be useful for detecting pediatric intussusception at an early stage. BMC Pediatr 2020;20:155. doi: 10.1186/s12887-020-02060-6, PMID 32284038

Hsiao HJ, Wang CJ, Lee CC, Hsin YC, Yau SY, Chen SY, et al. Point-of-care ultrasound may reduce misdiagnosis of pediatric intussusception. Front Pediatr 2021;9:601492. doi: 10.3389/fped.2021.601492, PMID 33614550

Dadlani A, Lal S, Shahani B, Ali M. Ultrasonography for the diagnosis of intussusception in children: An experience from Pakistan. Cureus 2020;12:e9656. doi: 10.7759/cureus.9656, PMID 32923254

Kim JH. US features of transient small bowel intussusception in pediatric patients. Korean J Radiol 2004;5:178-84. doi: 10.3348/ kjr.2004.5.3.178, PMID 15467415

Bai YZ, Qu RB, Wang GD, Zhang KR, Li Y, Huang Y, et al. Ultrasoundguided hydrostatic reduction of intussusceptions by saline enema:A review of 5218 cases in 17 years. Am J Surg 2006;192:273-5. doi:10.1016/j.amjsurg.2006.04.013, PMID 16920416

Chang YJ, Huang JL, Wu CT, Yan DC, Chao HC, Kong MS. Validation of ultrasound for intussusception at pediatric emergency department. Pediatr Res 2011;70:570. doi: 10.1038/pr.2011.795

Bai YZ, Qu RB, Wang GD, Zhang KR, Li Y, Huang Y, et al. Ultrasound-guided hydrostatic reduction of intussusceptions by saline enema: A review of 5218 cases in 17 years. Am J Surg 2006;192:273-5. doi: 10.1016/j.amjsurg.2006.04.013, PMID 16920416

Flaum V, Schneider A, Ferreira CG, Philippe P, Sancho CS, Lacreuse I, et al. Twenty years’ experience for reduction of ileocolic intussusceptions by saline enema under sonography control. J Pediatr Surg 2016;51:179-82. doi: 10.1016/j.jpedsurg.2015.09.022, PMID 26592955

Gondek AS, Riaza L, Cuadras D, Castellarnau XT, Krauel L. Ileocolic intussusception: predicting the probability of success of ultrasound guided saline enema from clinical and sonographic data. J Pediatr Surg 2018;53:599-604. doi: 10.1016/j.jpedsurg.2017.10.050, PMID 29150367

Menke J, Kahl F. Sonography-guided hydrostatic reduction of ileocolic intussusception in children: Analysis of failure and success in consecutive patients presenting timely to the hospital. Eur J Pediatr 2015;174:307-16. doi: 10.1007/s00431-014-2394-3, PMID 25132464

Daneman A, Navarro O. Intussusception, Part 2: An update on the evolution of management. Pediatr Radiol 2004;34:97-108; quiz 187. doi: 10.1007/s00247-003-1082-7, PMID 14634696

Beasley S. Intussusception. Pediatr Radiol 2004;34:302-4. doi: 10.1007/s00247-003-1074-7, PMID 15024529

Daneman A, Navarro O. Intussusception, Part 2: An update on the evolution of management. Pediatr Radiol 2004;34:97-108; quiz 187. doi: 10.1007/s00247-003-1082-7, PMID 14634696

Meyer JS, Dangman BC, Buonomo C, Berlin JA. Air and liquid contrast agents in the management of intussusception: A controlled, randomized trial. Radiology 1993;188:507-11. doi: 10.1148/ radiology.188.2.8327705, PMID 8327705

Limchareon S, Boonyarit A. A nine case series of ultrasound-guided hydrostatic reduction of intussusception by saline enema. ASEAN J Radiol 2023;19:61-71. doi: 10.46475/aseanjr.v19i1.23

Published

07-05-2023

How to Cite

YADAV, N., R. N. HIREMATH, P. DHAGAT, K. LEELAKANTH, and R. RAJ. “CLINICO-RADIOLOGICAL FEATURES IN CORROBORATION WITH INTRAOPERATIVE FINDINGS OF INTUSSUSCEPTION IN INFANTS-LESSONS LEARNED FROM CASES SERIES IN REMOTE SET UP DURING OVERSEAS DEPLOYMENT (EAST AFRICA)”. Asian Journal of Pharmaceutical and Clinical Research, vol. 16, no. 5, May 2023, pp. 7-10, doi:10.22159/ajpcr.2023.v16i5.46713.

Issue

Section

Case Study(s)

Most read articles by the same author(s)

1 2 > >>