The Diagnostic Accuracy of Sonography in Children Suspecting Intussusception Keeping Surgical Findings As Gold Standard

Abstract

Background: Intussusception occurs when a segment of bowel invaginates into an immediately adjacent segment, often likened to a telescope. Ultrasound is the primary imaging modality for initial diagnosis with high accuracy approaching 100% with sensitivity of 98% to 100% and specificity of 88% to 100%. It also help to determine whether the involved bowel should be reduced or surgically resected.

Objective: To evaluate the diagnostic accuracy of sonography in children suspecting intussusception keeping surgical findings as a gold standard.

Methods: Total 192 children presented with clinical triad of colicky abdominal pain, vomiting and jelly stools since last 5 hours were included. Ultrasound was performed and serial longitudinal and transverse images were assessed. All the patients diagnosed as having signs of irreducible intussusception like free fluid, absent blood flow on color Doppler were followed after surgery. Sensitivity, specificity, and accuracy of ultrasound were calculated using surgical procedure as gold standard.

Results: The male were 109(56.8%) and female were 83(43.2%). The mean age was 4.3±2.3 years. On ultrasound examination, intussusception was diagnosed in 33 patients. In surgical procedure it was diagnosed in 31 patients. The overall sensitivity of ultrasound was 83.9%, specificity was 95.7% and diagnostic accuracy was 93.7%.

Conclusion: Ultrasonography is an accurate, safe and valuable clinical tool in the diagnosis of acute intussusception in children.

Key Words: Diagnostic Accuracy, Ultrasonography,  intussusceptions, surgical findings