Role of multidetector computed tomography (MDCT) in diagnosis of secondary intussusception in children

Abstract

 Introduction: Intussusception occurs when a segment of bowel, the intussusceptum, prolapses and invaginates into another segment, the intussuscipiens. It is the most common cause of acute bowel obstruction in infants. Over 90% of childhood intussusceptions are idiopathic, perhaps related to relative hyperplasia of lymphoid follicles in the distal ileum. Underlying pathologic lead points are uncommon. Lymphoma, polyps, Meckel’s diverticulum and hematoma are most common identified lead points in children.
Aim of the work: To assess the role of multidetector computed tomographic imaging in the diagnosis of secondary intussusception with pathological leading points in children.
Materials and methods: This study is a retrospective study including 12 children referred to the radiodiagnosis department at Alexandria University Hospitals presenting with signs of acute abdomen, in the period between June 2012 and January 2013, all of which were radiologically diagnosed by computed tomographic imaging as secondary intussusception with pathological leading points which were confirmed by surgery. All the studied patients were subjected to full history taking, thorough clinical examination, laboratory investigations and CT of the abdomen and pelvis: using multidetector row CT.
Results: All the patients were radiologically diagnosed by computed tomographic imaging as secondary intussusception with pathological leading points which were confirmed by surgery. The associated leading points detected in our cases were reactive mesenteric lymph nodes in three patients, lymphoma in four cases, one post appendectomy case, mesenteric lymphangioma in one case,  malrotation in one case and Meckel’s diverticulum in another one case. Intramural hematoma was detected in one case diagnosed as Henoch–Scho¨ nlein purpura (8.33%).
Conclusions: Finally we conclude that multidetector CT could efficiently diagnose children presenting with secondary intussusceptions.

KEYWORD MDCT intussusception