Value of both ultrasonography and barium enema in diagnosis and reduction of intussusception in children

ABSTRACT

The aim of this study was to evaluate the values of both U/S and barium enema in diagnosis and hydrostatic reduction of acute non complicated intussusception in children. All these selected patients had no signs or symptoms of peritonitis with balanced serum electrolytes and the duration of symptoms was less than 48 hrs. Nasogastric tube inserted to decompress the stomach and IV cannula inserted for IV fluid replacement and sedated by diazepam. The diagnostic accuracy and sensitivity by both U/S and barium enema was 100% with positive sonographic target signs of intussusception [dough nut sign in TS and pseudo-kidney sign in LS]. 20 patients with non complicated acute intussusception were subjected to non- surgical reduction. They were divided into two groups for hydrostatic reduction of intussusception Group A included ten patients subjected for reduction of intussusception by saline enema guided by U/S and Group B included also ten patients subjected for barium enema reduction under fluoroscopic guide. The results have shown that U/S was equal to barium enema in diagnosis of intussusception but U/S considered superior than barium enema in diagnosis and reduction of intussusception as it can detect another abdominal pathology that could not be diagnosed by barium enema as well as it can save the patient from the hazards of irradiation. Also, the results have revealed that hydrostatic reduction must be fulfilled to non complicated intussusception to save the patients from the hazards and cost of surgical treatment that must be done only in cases of failed hydrostatic reduction and in complicated cases