Ultrasonography is accurate enough for the diagnosis of intussusception.

For more than 10 years the authors have been using ultrasonography to confirm clinically suspected intussusception without performing a contrast enema. The aim of this study is to review this diagnostic policy. Between 1980 and 1989, 163 children who, on clinical examination and plain abdominal radiographs were suspected of having intussusception, underwent ultrasonography to confirm the diagnosis. In 33 children, ultrasonography did not show intussusception; of the remaining 130 children, intussusception was diagnosed in 128. In two children in whom intussusception was noted subsequently, the diagnosis was not established on ultrasound. Thus, ultrasonography had a sensitivity of 98.5% and a specificity of 100% in the diagnosis of intussusception. It is a quick, simple, noninvasive method to diagnose intussusception, with high accuracy. The role of contrast enema is limited to therapeutic application.

Treatment of intussusception in children operative treatment versus hydrostatic reduction.

Intestinal intussusception is a serious abdominal emergency in infancy and childhood, with a high mortality-rate if not diagnosed and treated early. Since the management of intussusception in children is still controversial, the pro's and con's for barium enema reduction and for surgical treatment are discussed. The results of our own series of 19 patients primarily treated by barium-enema reduction compare favourably with a previous series of 14 patients treated by primary surgery.