Intussusception in Children: Diagnostic Imaging and Treatment

Intussusception is an acquired invagination of the bowel into itself; it may occur anywhere along the length of the bowel from the stomach into the esophagus to the rectum. It is an emergency where a delay in diagnosis increases the risk of bowel perforation, obstruction, and necrosis.Ultrasound is the accepted imaging modality of choice for the initial evaluation and diagnosis of intussusception. It has higher accuracy for diagnosis of intussusception than plain radiographs and higher diagnostic accuracy in identifying pathologic lead points and complications than plain radiographs or fluoroscopy-guided enema. Additionally, ultrasound is now more widely available than other imaging methods. There is no role for CT or MRI in the initial diagnosis of intussusception. However, CT can accurately diagnose intussusception in cases outside the typical age range or with atypical clinical presentation.Image-guided enema is widely accepted for the initial management of intussusception. Most studies suggest equivalency between fluoroscopic and ultrasound guidance regarding successful reduction rates, recurrence, and outcomes.