TY - JOUR
T1 - The role of abdominal x-rays in the diagnosis and management of intussusception
AU - Smith, Douglas S.
AU - Bonadio, William A.
AU - Losek, Joseph D.
AU - Walsh-Kelly, Christine M.
AU - Hennes, Halim M.
AU - Glaeser, Peter W.
AU - Melzer-Lange, Marlene
AU - Rimm, Alfred A.
PY - 1992/12
Y1 - 1992/12
N2 - The management of intussusception requires early diagnosis and reduction with either barium enema or surgical intervention. Supine and erect abdominal radiographs are often obtained prior to ordering a barium enema. In many pediatric centers, the critical, initial interpretation of these radiographs is made by nonradiologists and, in most instances, by pediatric emergency physicians. We determined the sensitivity and specificity of abdominal radiographs in diagnosing intussusception when interpreted by these physicians. Six full-time pediatric emergency physicians evaluated 126 radiographs from 42 patients with intussusception, 42 in whom the disease was clinically suspected but ruled out, and 42 in whom the final radiology report was “normal.” These were presented to pediatric emergency physicians in a blinded, randomized sequence without any additional clinical information. These physicians then identified patients for whom they would proceed to barium enema. The mean sensitivity was 80.5% (range, 71–93%), and the mean specificity was 58% (range, 48–69%). This compares favorably to the sensitivity of signs and symptoms, and we conclude that plain and upright abdominal films are a useful adjunct for the clinician evaluating patients for suspected intussusception.
AB - The management of intussusception requires early diagnosis and reduction with either barium enema or surgical intervention. Supine and erect abdominal radiographs are often obtained prior to ordering a barium enema. In many pediatric centers, the critical, initial interpretation of these radiographs is made by nonradiologists and, in most instances, by pediatric emergency physicians. We determined the sensitivity and specificity of abdominal radiographs in diagnosing intussusception when interpreted by these physicians. Six full-time pediatric emergency physicians evaluated 126 radiographs from 42 patients with intussusception, 42 in whom the disease was clinically suspected but ruled out, and 42 in whom the final radiology report was “normal.” These were presented to pediatric emergency physicians in a blinded, randomized sequence without any additional clinical information. These physicians then identified patients for whom they would proceed to barium enema. The mean sensitivity was 80.5% (range, 71–93%), and the mean specificity was 58% (range, 48–69%). This compares favorably to the sensitivity of signs and symptoms, and we conclude that plain and upright abdominal films are a useful adjunct for the clinician evaluating patients for suspected intussusception.
KW - Abdominal radiographs
KW - Intussusception
UR - http://www.scopus.com/inward/record.url?scp=0026496076&partnerID=8YFLogxK
U2 - 10.1097/00006565-199212000-00004
DO - 10.1097/00006565-199212000-00004
M3 - Article
C2 - 1454638
AN - SCOPUS:0026496076
SN - 0749-5161
VL - 8
SP - 325
EP - 327
JO - Pediatric Emergency Care
JF - Pediatric Emergency Care
IS - 6
ER -