Document Detail


Ultrasonographic and clinical predictors of intussusception.
MedLine Citation:
PMID:  9602196     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of this study was to determine the positive and negative clinical predictors of intussusception and the correlation of ultrasonography and air enema in establishing this diagnosis. STUDY DESIGN: This was a prospective descriptive cohort study. SETTING: This study was performed in a tertiary care pediatric emergency department. PARTICIPANTS: Eighty-eight of 245 candidates were assessed for clinical predictors of intussusception. All 245 cases were examined for correlation between ultrasonography and air enema. INTERVENTIONS: A questionnaire, ultrasonography, and air enema were used. RESULTS: Thirty-five of the 88 patients assessed for clinical predictors were positive for intussusception. Significant positive predictors were right upper quadrant abdominal mass (positive predictive value [PPV] 94%), gross blood in stool (PPV 80%), blood on rectal examination (PPV 78%), the triad of intermittent abdominal pain, vomiting, and right upper quadrant abdominal mass (PPV 93%, p = 0.0001), and the triad with occult or gross blood per rectum (PPV 100%, p = not significant). Significant negative predictors were a combination of > or = 3 of 10 clinically significant negative features (negative predictive value 77%, p = 0.035). Of the total 245 cases, intussusception (as confirmed by doughnut, target, or pseudokidney sign) was ruled out by ultrasonography in 97.4%. Alternate ultrasound findings comprised 27% of negative cases. CONCLUSIONS: Excellent positive predictors of intussusception were identified prospectively. Although no reliable negative predictors were found, patients at low risk may be screened by ultrasonography.
Authors:
L Harrington; B Connolly; X Hu; D E Wesson; P Babyn; S Schuh
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  132     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  1998 May 
Date Detail:
Created Date:  1998-06-18     Completed Date:  1998-06-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  836-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Air
Child, Preschool
Emergency Service, Hospital
Enema / methods
Female
Humans
Infant
Intussusception / diagnosis*,  physiopathology,  ultrasonography*
Male
Predictive Value of Tests
Prospective Studies
Questionnaires

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


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