ULTRASOUND IN THE DIAGNOSIS AND EXCLUSION OF INTUSSUSCEPTION

Intussusception is a major cause of intestinal obstruction in infancy and childhood, Improved results of treatment have followed the increas ed use of ultrasound imaging and pneumatic reduction. We prospectively studied the value of ultrasound in both the diagnosis and exclusion o f intussusception in a peripheral paediatric unit over a four year per iod from October 1990 to October 1994. In all, 24 patients had a suspe cted clinical diagnosis of intussusception of which 19 had typical ult rasound findings. The male to female ratio was 8:11 and age at present ation ranged from 2 to 38 months (mean 11.4 months). There were no fal se negatives and 2 false positives giving a sensitivity of 100% and sp ecificity of 89%. Thus no intussusception was missed by ultrasound exa mination, Enema reduction was successful in 76% of cases and factors a ssociated with failure of enema reduction included passage of blood pe r rectum and symptoms for greater than 24 hours. We conclude that ultr asound should be used as a rapid and sensitive screening procedure in the diagnosis and exclusion.