Evaluation of critical diagnostic landmarks obtained from comparison of symptomatic small bowel intussusception relevant to surgically proven 16 pediatric cases

Q: What was the main aim of the study regarding pediatric small bowel intussusception?

The study evaluated clinical presentation, diagnostic approaches, treatment strategies, and outcomes in pediatric SBI, focusing on cases proven surgically.

Q: How were children grouped for analysis in this retrospective study?

Patients were divided into operative and non-operative groups based on whether they underwent surgical intervention.

Q: Which ultrasound findings and clinical features predicted the need for surgery?

Older age, a longer intussuscepted segment on ultrasound, and more severe symptoms predicted surgical need.

Sep 30, 2026

Uploaded by CatatanPagi

Study evaluates clinical presentation, diagnostic modalities, treatment strategies, and outcomes for pediatric small bowel intussusception (SBI) with emphasis on surgically treated cases. Records of children diagnosed with SBI from January 2018 to December 2023 were retrospectively reviewed, comparing operative versus non-operative groups using statistical tests and ROC analysis to identify an ultrasound threshold predicting surgery. Older age, longer ultrasound intussuscepted length, and severe symptoms predicted surgical need. A 4.0 cm cutoff yielded 100% sensitivity and 73.1% specificity.

LanguageEnglish

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Abstract

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ORIGINAL ARTICLE Evaluation of critical diagnostic landmarks obtained from comparison of symptomatic small bowel intussusception relevant to surgically proven 16 pediatric cases Gonca Gerçel,1,2 Ali İhsan Anadolulu,2 FurkanAdem Canbaz,1 Sefa Sağ1 1Department of Pediatric Surgery, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, Istanbul-Türkiye 2Department of Pediatric Surgery, Istanbul Medeniyet University, Faculty of Medicine, Istanbul-Türkiye ABSTRACT BACKGROUND: This study aims to evaluate the clinical presentation, diagnostic modalities, treatment strategies, and outcomes of pediatric small bowel intussusception (SBI), with a particular focus on surgically treated cases. METHODS: Records of children diagnosed with SBI between January 2018 and December 2023 were retrospectively reviewed. Demographics, clinical presentation, imaging findings, treatment approaches, and surgical outcomes were analyzed. Statistical comparisons were performed between operative and non-operative groups, and receiver operating characteristic (ROC) curve analysis was used to determine the optimal ultrasound threshold for predicting the need for surgery. RESULTS: Among 618 patients diagnosed with intussusception, 72 (11.6%) had SBI, of which 16 (2.6%) required surgery. Operative patients were significantly older (median: 75 months) than those managed non-operatively (median: 32 months) (p<0.05). Vomiting was significantly more common in the operative group (100% vs. 44.6%, p<0.001). The mean ultrasonographic length of the intussuscepted segment was significantly greater in the operative group (5.7±1.33 cm) than in the non-operative group (3.27±1.18 cm) (p<0.001). A cut-off value of 4.0 cm was identified as predictive for surgical intervention, with 100% sensitivity and 73.1% specificity. Pathologic lead points were found in 87.5% of surgical cases, although none were identified preoperatively. Hydrostatic reduction was successful in 62.5% of non-operative patients. CONCLUSION: This study emphasizes that older age, longer intussuscepted segment on ultrasound, and severe symptoms are predictive of surgical need in pediatric SBI. A 4.0 cm cutoff aids decision-making, while the limited detection of pathologic lead points (PLP) underscores the importance of clinical evaluation. Keywords: l bowel intussusception; children; surgery. INTRODUCTION Intussusception is the leading cause of intestinal obstruction in infants under two years of age and represents the second most common cause of acute abdomen in children, following acute appendicitis.[1] Approximately 90% of childhood intussusceptions are ileocolic in nature. Most cases are idiopathic; however, in a smaller proportion, an underlying pathologic lead point (PLP) is responsible.[2,3] Intussusceptions involving the small bowel are considered uncommon in the pediatric population, with an estimated prevalence of 8-16% among all childhood cases.[4] With the increasing use of ultrasound in recent years, small bowel intussusceptions (SBIs) are being identified more frequently than in the past. Although there are publications in the literature supporting that SBIs are transient and can be managed with conservative follow-up, a consid- | Cite this article as: Gerçel G, Anadolulu Aİ, Canbaz FA, Sağ S. Evaluation of critical diagnostic landmarks obtained from comparison of symptomatic small bowel intussusception relevant to surgically proven 16 pediatric cases. Ulus Travma Acil Cerrahi Derg 2025;31:937-943.
Address for correspondence: Gonca Gerçel
Department of Pediatric Surgery, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, Istanbul, Türkiye
E-mail: [goncagercel@gmail.com](goncagercel@gmail.com) | | | --- | --- | | Ulus Travma Acil Cerrahi Derg 2025;31(10):937-943 DOI: 10.14744/tjtes.2025.57522
Submitted: 05.09.2024 Revised: 03.09.2025 Accepted: 04.09.2025 Published: 07.10.2025
OPEN ACCESS This is an open access ar

FAQs

What was the main aim of the study regarding pediatric small bowel intussusception?

The study evaluated clinical presentation, diagnostic approaches, treatment strategies, and outcomes in pediatric SBI, focusing on cases proven surgically.

How were children grouped for analysis in this retrospective study?

Patients were divided into operative and non-operative groups based on whether they underwent surgical intervention.

Which ultrasound findings and clinical features predicted the need for surgery?

Older age, a longer intussuscepted segment on ultrasound, and more severe symptoms predicted surgical need.

Sep 30, 2026

Uploaded by CatatanPagi