Document Detail


Interloop fluid in intussusception: what is its significance?
MedLine Citation:
PMID:  21243350     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Sonography has been used to predict pneumatic reduction outcome in children with intussusception.
OBJECTIVE: To assess the prognostic significance of fluid between the intussusceptum and intussuscepiens with respect to reduction outcome, lead point or necrosis.
MATERIALS AND METHODS: Sonograms of children with a discharge diagnosis of intussusception from four institutions were reviewed for interloop fluid and correlated with results of pneumatic reduction and surgical/pathological findings when available. Maximal dimension of interloop fluid on a transverse image and fluid complexity were evaluated.
RESULTS: Of 166 cases, 36 (21.7%) had interloop fluid. Pneumatic reduction was successful in 21 (58.3%) with fluid and 113 (87.6%) without. The average largest fluid dimension was 8.7 mm (range 5 mm-19 mm, median 8 mm) in cases with successful reduction and 12.8 mm (range 4 mm-26 mm, median 12.5 mm) in unsuccessful reduction (p < 0.05). Fluid dimension equal to or greater than 9 mm correlated with failed reduction (p < 0.0001;odds ratio 13:1). In 36 cases with interloop fluid that required surgery, there were four lead points and three necrosis. In cases without fluid with surgical reduction, there was one lead point and one necrosis. Interloop fluid correlated with lead point (p < 0.04) or necrosis (p < 0.03). Its significance increased with larger amounts of fluid (p < 0.0001). Patient age/fluid complexity did not correlate with reduction outcome (p = 0.9).
CONCLUSION: Interloop fluid was associated with increased failure of pneumatic reduction and increased likelihood of lead point or necrosis, particularly when the maximum dimension exceeded 9 mm.
Authors:
Robyn D Gartner; Terry L Levin; Steven H Borenstein; Bokyung Kim Han; Einat Blumfield; Robyn Murphy; Katherine Freeman
Publication Detail:
Type:  Journal Article     Date:  2011-01-18
Journal Detail:
Title:  Pediatric radiology     Volume:  41     ISSN:  1432-1998     ISO Abbreviation:  Pediatr Radiol     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-12     Completed Date:  2011-09-30     Revised Date:  2011-11-22    
Medline Journal Info:
Nlm Unique ID:  0365332     Medline TA:  Pediatr Radiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  727-31     Citation Subset:  IM    
Affiliation:
Department of Radiology, Children's Hospital of Pennsylvania, Philadelphia, PA, USA.
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MeSH Terms
Descriptor/Qualifier:
Ascitic Fluid / ultrasonography*
Child
Child, Preschool
Female
Humans
Infant
Infant, Newborn
Intussusception / prevention & control*,  ultrasonography*
Male
Reproducibility of Results
Sensitivity and Specificity
Treatment Outcome
Ultrasonography / methods*
Comments/Corrections
Comment In:
Pediatr Radiol. 2011 Nov;41(11):1483   [PMID:  21928048 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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