The presence of trapped fluid on ultrasound as high predictive value for intestinal necrosis in pediatric intussusception

Abstract

Introduction: Intussusception is a pediatric emergency. If it is not treated immediately, the obstruction process can cause arterial obstruction and leads to intestinal necrosis. Not all patient shows classic syndrome triad. Thus, imaging is needed to make the diagnosis. Ultrasonography is the first choice of imaging in children because it is easy, without radiation and sedation. It has high accuracy for the diagnosis of intussusception. Ultrasonographic features of intussusception including target or doughnut sign and pseudo kidney sign. The presence of trapped fluid in intussusception, correlated with intestinal ischemia and necrosis found in surgery. This research aimed to assess sensitivity, specificity, and accuracy of trapped fluid in ultrasound examination compared with the intra-operative findings reported by surgeons in the form of intestinal necrosis in pediatric patients with intussusception in Saiful Anwar Hospital, Malang. Material and Methods: This research was observational analytic with a cross-sectional design. It used retrospective data of abdominal ultrasound results and surgical operating reports in 30 patients who were diagnosed with intussusception. Results: Trapped fluid depiction on ultrasound has a sensitivity of 80%, a specificity of 75%, and an accuracy of 76% with regards to necrotic bowel as compared to intra-operative findings. Conclusion: Trapped fluid in intussusception is a good predictor of intestinal necrosis in cases of intussusception in children.