POCUS for Intussusception

August 5, 2021

Written by Ashley Haggerty

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Ultrasound is a valuable tool to evaluate for intussusception by trained emergency physicians.

Why does this matter?
Infants ranging 3-12 months of life with intussusception will often present with colicky abdominal pain and excessive crying. As the inflammation progresses, they will begin to vomit. If bowel ischemia occurs, they can present with blood per rectum. However, since less than 20% will present with the textbook triad of symptoms (abdominal pain, vomiting, and bloody stools), ultrasound is an accurate investigative modality to explore the cause of their symptoms as it is safe, non-radiating, and accessible. We have covered the accuracy of exam, x-ray, and POCUS before. This is another look focusing solely on ultrasound accuracy.

Instead of white noise to soothe those colicky cries, try ultrasound-waves!
A meta-analysis was performed on 14 studies (11 retrospective, 3 prospective) with the search strategy including “ultrasound” or “sonography” or “ultrasonography” or “ultrasonic” or “US” and “intussusception” or “intestinal invagination.” These studies included emergency physician and sonographer performed studies and captured a sample of 2,367 children. The systematic review revealed a pooled sensitivity of 0.94 (95% confidence interval 0.91-0.96), specificity of 0.96 (95%CI 0.93-0.98), positive likelihood ratio of 21.8 (95%CI 12.5-38.0), a negative likelihood ratio of 0.06 (95%CI of 0.04-0.10), and a diagnostic odds ratio of 359 (95%CI of 146-882) for using ultrasound to diagnose intussusception. Combat those colicky cries with ultrasound waves. Bedside ultrasound is an effective and accurate tool and should be widely used in identifying intussusception.

Source
Ultrasonographic Diagnosis of Intussusception in Children: A Systematic Review and Meta-Analysis. J Ultrasound Med. 2021 Jun;40(6):1077-1084. doi: 10.1002/jum.15504. Epub 2020 Sep 16.