Intussusception x ray
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American Roentgen Ray Society Images of Intussusception |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sargun Singh Walia M.B.B.S.[2]
Overview
An x-ray may be helpful in the diagnosis of intussusception. Plain abdominal xray of patient is done in supine and upright position. Findings on an x-ray suggestive of/diagnostic of intussusception include absence of air in right lower quadrant and right upper quadrant, soft tissue density in right upper quadrant in 25-60% of patients, and normal in 60% of cases.
X Ray Images
Plain film
- An x-ray may be helpful in the diagnosis of intussusception. Findings on an x-ray suggestive of/diagnostic of intussusception include:
- Normal in 60% of cases
- Absence of air in right lower quadrant and right upper quadrant
- Soft tissue density in right upper quadrant in 25-60% of patients
- Distended loops of bowel with absence of colonic gas (sign of intestinal obstruction)
- Target sign[1]
- Two concentric radiolucent circles superimposed on the right kidney
- This signifies peritoneal fat around the intussusception
- A study shows target sign is present in 26% of patients[2]
- Crescent sign
- A soft tissue density projecting into the gas of the large bowel
- Concealed liver margin[3]
- Xrays cannot be used to exclude intussusception in patients where suspicion of intussusception is very high[4]
- Sensitivity is 48%
- Specificity is 21%
- A study conducted on patients of intussusception showed negative x-ray findings in 20%[5]
- If suspicion of intussusception is low in a patient. X-ray showing air in the cecum or terminal ileum can exclude intussusception[6]
- An x-ray can be used in cases of low suspicion. But, ultrasound is superior in diagnosing and excluding intussusception
References
- ↑ Ratcliffe JF, Fong S, Cheong I, O'Connell P (1992). "Plain film diagnosis of intussusception: prevalence of the target sign". AJR Am J Roentgenol. 158 (3): 619–21. doi:10.2214/ajr.158.3.1739006. PMID 1739006.
- ↑ Ratcliffe JF, Fong S, Cheong I, O'Connell P (1992). "Plain film diagnosis of intussusception: prevalence of the target sign". AJR Am J Roentgenol. 158 (3): 619–21. doi:10.2214/ajr.158.3.1739006. PMID 1739006.
- ↑ Saverino BP, Lava C, Lowe LH, Rivard DC (2010). "Radiographic findings in the diagnosis of pediatric ileocolic intussusception: comparison to a control population". Pediatr Emerg Care. 26 (4): 281–4. PMID 20401973.
- ↑ Carroll AG, Kavanagh RG, Ni Leidhin C, Cullinan NM, Lavelle LP, Malone DE (2017). "Comparative Effectiveness of Imaging Modalities for the Diagnosis and Treatment of Intussusception: A Critically Appraised Topic". Acad Radiol. 24 (5): 521–529. doi:10.1016/j.acra.2017.01.002. PMID 28268146.
- ↑ Weihmiller SN, Buonomo C, Bachur R (2011). "Risk stratification of children being evaluated for intussusception". Pediatrics. 127 (2): e296–303. doi:10.1542/peds.2010-2432. PMID 21242220.
- ↑ Roskind CG, Kamdar G, Ruzal-Shapiro CB, Bennett JE, Dayan PS (2012). "Accuracy of plain radiographs to exclude the diagnosis of intussusception". Pediatr Emerg Care. 28 (9): 855–8. doi:10.1097/PEC.0b013e318267ea38. PMID 22929143.