Diagnostic Accuracy of Ultrasonography in Pediatric Intussception Taking Surgical Findings as Gold Standard

Abstract

Objective: The objective of this study is to determine diagnostic accuracy of ultrasonography for diagnosis of Intussusception in children taking surgical findings as gold standard. Study Design: Cross sectional study Place and Duration of Study: The department of Pediatricsurgery,Children Hospital and Institute of Child Health, Lahore and PIMS Children Hospital,Islamabad during the time period from June 2019 to May 2021. Methodology: 170 children fulfilling inclusion criteria were taken. After taking informed consent from parents or attendants of the children a detailed history was taken regarding their age, gender and address. All patients with symptoms and signs such as vomiting, abdominal pain and/or distension, rectal bleeding, pallor or lethargy were admitted. They were examined and investigated through ultrasound. The final diagnosis of Intussusception was confirmed on surgery by expert consultant with experience more than 5 years after postgraduation. Ultrasonographic images taken at the time of diagnosis were obtained. Results: The mean age of children was 3.56±3.29 years with 105(61.8%)male children and 65(38.2%)females.The Ultrasound results showed positive result in 97 (57.1%) children and negative in 73 (42.9%) children.The Surgical findings showed positive results in 107 (62.9%) and negative in 63 (37.1%) children.The sensitivity, specificity, Negative Predictive Value (NPV), and Positive Predictive Value (PPV) for ultrasound keeping surgical findings in diagnosis of intussusception were 85.05%, 90.48%, 93.81%, and 78.08% respectively, whereas, the overall diagnostic accuracy was 87.06%. Conclusion: It is concluded that ultrasonography for diagnosis of Intussusception in children is very useful diagnostic modality. USG can help us for prompt and timely diagnosis and early surgical intervention can be done to minimize morbidity related to delayed diagnosis. Keywords:Intussusception, Abdominal surgery, Imaging, Ultrasound, Accuracy