POCUS helpful for differentiating intussusception in pediatric patients: Study
USA: Point-of-care ultrasound (POCUS) can differentiate ileocolic intussusception (ICI) from small bowel-small bowel intussusception (SB-SBI) and is thus helpful in pediatric emergencies, a recent study has found. The study findings are published in The Journal of Emergency Medicine.
Intussusception is a common emergency among children. Two types of intussusception are small bowel–small bowel intussusception and ileocolic intussusception, and neither of them can be distinguished easily clinically. ICI requires surgical assistance and radiology personnel for its reduction. SB-SBI is managed expectantly, as many resolve spontaneously.
Differentiation between the two types of intussusception through POCUS requires an understanding of their salient features. Identifying the correct type of intussusception immediately assists patient disposition and decision-making.
Against the above background, Sathyaseelan Subramaniam, Emergency Department, Summerlin Hospital Medical Center, Las Vegas, Nevada, and the team aimed to provide guidance on the POCUS technique for intussusception identification and to review the ultrasound literature differentiating ICI from SB-SBI.
For this purpose, the team systematically searched 3 separate databases and gray literature to identify articles that met their criteria and assessed them for final review. The final articles were graded for quality using The National Institutes of Health quality assessment tool for observational cohort and cross-sectional studies.
A total of 858 articles were identified. Six articles were included in the final review.
The study yielded the following findings:
- All studies were conducted in pediatric patients in different countries. Most were found to have a fair quality of evidence.
- The linear transducer is used when evaluating intussusception.
- Both ICI and SB-SBI are identified easily on POCUS, but they differ sonographically with respect to region within the abdomen, intussusception parameters, lymph nodes, and other salient features seen on real-time video.
The researchers concluded, "ICI and SB-SBI can be identified and differentiated using several sonographic features. POCUS is capable of expeditiously aiding the emergency physician's decision making and disposition when managing intussusception."
Reference:
The study titled, "Point-of-Care Ultrasound For Differentiating Ileocolic From Small Bowel-Small Bowel Intussusception," is published in The Journal of Emergency Medicine.
DOI: https://www.jem-journal.com/article/S0736-4679(21)00540-0/fulltext
