Point-of-care ultrasound may be useful for detecting pediatric intussusception at an early stage

Abstract Background This study aimed to verify the usefulness of point-of-care ultrasound (POCUS) performed by pediatric emergency physicians for detecting intussusception at an early stage. Methods This retrospective study included 1-month- to 6-year-old children with clinically suspected intussusc...

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Main Authors: Jeong-Yong Lee, Jung Heon Kim, Seung Jun Choi, Jong Seung Lee, Jeong-Min Ryu
Format: Article
Language:English
Published: BMC 2020-04-01
Series:BMC Pediatrics
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12887-020-02060-6
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author Jeong-Yong Lee
Jung Heon Kim
Seung Jun Choi
Jong Seung Lee
Jeong-Min Ryu
author_facet Jeong-Yong Lee
Jung Heon Kim
Seung Jun Choi
Jong Seung Lee
Jeong-Min Ryu
author_sort Jeong-Yong Lee
collection DOAJ
description Abstract Background This study aimed to verify the usefulness of point-of-care ultrasound (POCUS) performed by pediatric emergency physicians for detecting intussusception at an early stage. Methods This retrospective study included 1-month- to 6-year-old children with clinically suspected intussusception, who underwent POCUS in the pediatric emergency department between December 2016 and February 2018. The criteria for performing POCUS were set to broader standards: presenting any one of intermittent abdominal pain/irritability or bloody stool, or ≥ 2 symptoms among nonspecific abdominal pain/irritability, abdominal mass/distension, vomiting, or lethargy. POCUS results were interpreted and categorized as “negative” or “suspicious,” and a radiologist performed confirmatory ultrasound in “suspicious” cases. Results We analyzed 575 POCUS scans from 549 patients (mean age, 25.5 months). Among the 92 “suspicious” cases (16.0%), 70 (12.2%) were confirmed to have intussusception. POCUS showed 100% sensitivity, 95.6% specificity, and 97.8% accuracy. Patients with confirmed intussusception were mainly diagnosed in the early stages, with a mean symptom duration of 11.7 h, and most patients (97.1%) were treated successfully via air enema reduction. Compared to the non-intussusception group, the intussusception group had more intermittent abdominal pain (P < 0.001), but less vomiting (P = 0.001); the other clinical features showed no intergroup differences. Conclusion POCUS performed using the criteria set to broader standards by pediatric emergency physicians may be useful for detecting intussusception at an early stage, which may present with obscure clinical symptoms.
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spelling doaj.art-d5055a7c16d14d548e9d4621df1439302022-12-22T02:41:45ZengBMCBMC Pediatrics1471-24312020-04-012011610.1186/s12887-020-02060-6Point-of-care ultrasound may be useful for detecting pediatric intussusception at an early stageJeong-Yong Lee0Jung Heon Kim1Seung Jun Choi2Jong Seung Lee3Jeong-Min Ryu4Department of Pediatrics, Asan Medical Center, University of Ulsan College of MedicineDepartment of Emergency Medicine, Ajou University School of MedicineDepartment of Pediatrics, Asan Medical Center, University of Ulsan College of MedicineDepartment of Emergency Medicine, Asan Medical Center, University of Ulsan College of MedicineDepartment of Emergency Medicine, Asan Medical Center, University of Ulsan College of MedicineAbstract Background This study aimed to verify the usefulness of point-of-care ultrasound (POCUS) performed by pediatric emergency physicians for detecting intussusception at an early stage. Methods This retrospective study included 1-month- to 6-year-old children with clinically suspected intussusception, who underwent POCUS in the pediatric emergency department between December 2016 and February 2018. The criteria for performing POCUS were set to broader standards: presenting any one of intermittent abdominal pain/irritability or bloody stool, or ≥ 2 symptoms among nonspecific abdominal pain/irritability, abdominal mass/distension, vomiting, or lethargy. POCUS results were interpreted and categorized as “negative” or “suspicious,” and a radiologist performed confirmatory ultrasound in “suspicious” cases. Results We analyzed 575 POCUS scans from 549 patients (mean age, 25.5 months). Among the 92 “suspicious” cases (16.0%), 70 (12.2%) were confirmed to have intussusception. POCUS showed 100% sensitivity, 95.6% specificity, and 97.8% accuracy. Patients with confirmed intussusception were mainly diagnosed in the early stages, with a mean symptom duration of 11.7 h, and most patients (97.1%) were treated successfully via air enema reduction. Compared to the non-intussusception group, the intussusception group had more intermittent abdominal pain (P < 0.001), but less vomiting (P = 0.001); the other clinical features showed no intergroup differences. Conclusion POCUS performed using the criteria set to broader standards by pediatric emergency physicians may be useful for detecting intussusception at an early stage, which may present with obscure clinical symptoms.http://link.springer.com/article/10.1186/s12887-020-02060-6ChildDiagnosisEmergency service, hospitalIntussusceptionPoint-of-care systemsUltrasonography
spellingShingle Jeong-Yong Lee
Jung Heon Kim
Seung Jun Choi
Jong Seung Lee
Jeong-Min Ryu
Point-of-care ultrasound may be useful for detecting pediatric intussusception at an early stage
BMC Pediatrics
Child
Diagnosis
Emergency service, hospital
Intussusception
Point-of-care systems
Ultrasonography
title Point-of-care ultrasound may be useful for detecting pediatric intussusception at an early stage
title_full Point-of-care ultrasound may be useful for detecting pediatric intussusception at an early stage
title_fullStr Point-of-care ultrasound may be useful for detecting pediatric intussusception at an early stage
title_full_unstemmed Point-of-care ultrasound may be useful for detecting pediatric intussusception at an early stage
title_short Point-of-care ultrasound may be useful for detecting pediatric intussusception at an early stage
title_sort point of care ultrasound may be useful for detecting pediatric intussusception at an early stage
topic Child
Diagnosis
Emergency service, hospital
Intussusception
Point-of-care systems
Ultrasonography
url http://link.springer.com/article/10.1186/s12887-020-02060-6
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