To analyze the causes of failure to reduce acute infantile intussusception with gas enema. 441 cases of acute infantile intussusception in our hospital who failed to be reduced with gas-enema, and underwent the operative therapy were analyzed. Result: 92 cases (20.9%) were intestinal necrosis, 184 cases (41.7%) double intussusception, 27 cases (6.1%) organic pathological changes and 8 cases (1.8%) intestinal perforation caused by gas-enema reduction. All the cases had a successful recovery after surgery. Conclusion: The main causes of failure to reduction with gas-enema were as follows: ①double intussusception, ②intestinal necrosis, ③late for visiting a doctor, ④organic pathological changes, ⑤perforation (in the process of gas-enema reduction). The importance of early diagnosis is emphasized.
Objective To investigate the value of the multi-detector row spiral CT (MDCT) and 3-dimensional reconstruction technique for adult intussusception. Methods Twenty-one patients with surgically and clinical following-up confirmed intussusception were retrospectively included into this study. Three patients had plain MDCT scan, 18 received contrast enhanced MDCT scan. The original images were reconstructed with multi-planar reconstruction (MPR) technique and all the images of 21 patients were divided into original image group and original image add MPR image group. Two abdominal radiologists analyzed the MDCT imaging and recorded respectively the accuracy rate and the confidence index of the doctor about following indexes: whether or not having intussusception, the location of intussusception, finding reason caused intussusception, whether or not having bowel wall ischemia and whether or not having bowel obstruction. The accuracy rate and the confidence index of the doctor were compared using a SPSS statistics software. Results The accuracy rates about above indexes between original image group and original image add MPR image group were 90.5% (19/21) vs. 100% (21/21), 81.0% (17/21) vs. 95.2% (20/21), 85.7% (18/21) vs. 90.5% (19/21), 90.9% (10/11) vs. 90.9% (10/11) and 100% (11/11) vs. 100% (11/11) respectively, and there was no significant difference between original image group and original image add MPR image group (Pgt;0.05). For following indexes: whether or not having intussusception, the location of intussusception, finding reason caused intussusception, the confidence index of the doctor between original image add MPR image group and original image group had significant difference (5.00 vs. 4.24, 4.76 vs. 4.29, 4.29 vs. 3.71), and the confidence index of the doctor of original image add MPR image group exceeded that of original image group (Plt;0.05). Conclusions MDCT plays a valuable role in diagnosis and location of intussusception, finding the reason caused intussusception and evaluation the hemodynamic impairment of being involved in bowel wall. Compared to simple axial image, axial image combine 3-dimensional reconstructed image can increase the diagnostic confidence of the doctor.
ObjectiveTo study the clinical significance of color Doppler ultrasound in the diagnosis of intussusception in children. MethodsWe retrospectively analyzed the color Doppler ultrasound results of 150 children with intussusception confirmed by X-ray air enema and surgery between January 2010 and December 2012. ResultsThe 150 children included 18 cases of necrosis, and 132 cases of simple edema; there were 122 cases of ileocecal intussusception, 22 cases of colon, and 6 of small intestine. Surgical treatment was performed for 30 cases, and 120 cases were treated with X-ray air enema reduction. Ultrasonic diagnosis was correct in 144 cases with an accurate rate of 96.0%; 6 cases were misdiagnosed, and misdiagnosis rate was 4.0%. ConclusionUltrasound in the diagnosis of children intussusception is simple, rapid, non-invasive, with no side-effects of radiation exposure, and selection of this method clinically has a very important significance.