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  3. 39. Diagnosing Pediatric Intussusception: Reliability of Sonographic Findings in Comparison to Operative Findings - A Short Term Analysis in Two Tertiary Care Hospitals
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39. Diagnosing Pediatric Intussusception: Reliability of Sonographic Findings in Comparison to Operative Findings - A Short Term Analysis in Two Tertiary Care Hospitals

Shahid Manzur1 and Ahsen Farooq2

ABSTRACT

Objective: To review the reliability of ultrasonography for the screening and diagnosis of intussusception in clinically suspected children examined in radiology departments of two tertiary care hospitals in comparison to operative findings. 

Study Design: Cross-sectional study.

Place and Duration of Study: The study was conducted collaboratively in the Departments of Radiology, Pakistan Railway General Hospital, Rawalpindi and Bahawal Victoria Hospital, Bahawalpur from January 2013 to December 2014.

Materials and Methods: A total of 113 children with age ranging from 0-5 years of both gender having clinical features of suspected intussusception were included in the study. Patients with stomas, history of previous surgery, patients with known congenital intestinal anomalies and haemodynamically unstable patients were excluded. All these patients had undergone ultrasound of abdomen and pelvis. The sonographic findings were recorded as positive and negative for intussusception. The criteria for positivity included the “target or doughnut sign” on transverse view and the “pseudo kidney sign” in longitudinal view respectively. Subsequently all these patients underwent exploratory laparotomy and intra-operative findings were recorded and correlated with sonogaphic findings to determine diagnostic reliability of ultrasonography.  

Results: Ultrasonography supported the diagnosis of intussusception in 76 (67.26%) patients. Operative findings confirmed intussusception in 79 (69.91%) cases whereas 34 (30.01%) patients revealed no intussusception.  There was one false positive and four false negative results on ultrasonography. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of grey scale ultrasonography in intussusception in children were 94.94%, 97.06%, 98.68%, 89.19% and 95.57% respectively.

Conclusion: The sensitivity and specificity of sonographic findings for screening and diagnosing the intussusception as reported by the Radiology Departments of the two hospitals and confirmed with operative findings, were consistent with previous studies published locally and internationally.

Key Words: Intussusception, Children, Ultra-sonography, Screening, Diagnosis, Railway Hospital

Citation of article: Manzur S, Farooq A. Diagnosing Pediatric Intussusception: Reliability of Sonographic

Findings in Comparison to Operative Findings - A Short Term Analysis in Two Tertiary Care Hospitals. Med

 

Forum 2017;28(6):153-157.