Emergency bedside ultrasound for the diagnosis of pediatric intussusception： a retrospective review

摘要

BACKGROUND： Ultrasound diagnosis of pediatric intussusception is feasible with limitedoperator training. The authors report the test characteristics of bedside ultrasound （BUS） for thediagnosis of pediatric intussusception at a single institution.METHODS： Inclusion criteria were： 1） patients of 0-18 years old were seen in the pediatricemergency department （ED） with a clinical presentation suspicious for intussusception; 2） BUS wasperformed to identify intussusception and bedside impression documented in the medical record; 3） a＂formal＂ diagnostic study （such as computed tomography, ultrasound, or barium enema） was performedby the radiology department after BUS was completed. Electronic medical record and ED BUS archivewere screened for potentially eligible ED visits between January 1st 2009 to October 3rd 2012. Theserecords were then reviewed to identify patients for inclusion in the study. All emergency physicians whoperformed the BUS had undergone a minimum of 1-hour didactic training on the use of BUS to diagnosepediatric intussusception.RESULTS： A total of 1 631 charts were reviewed, with 49 meeting inclusion criteria. Fiveof those were later excluded for incomplete documentation or lack of saved BUS images. Theprevalence of intussusception was 23%. The mean age of the subjects was 31 months. BUS was100% sensitive （95%CI 66%-100%） and 94% specifi c （95%CI 79%-99%） for detection of pediatricintussusception compared to radiology study results. Positive and negative likelihood ratios were 16.5（95%CI 4.30%-63.21%） and 0 （95%CI 0-0） respectively.CONCLUSIONS： BUS is an accurate means of diagnosing acute intussusception in pediatricpatients. Further study might be indicated to confi rm such benefi ts.