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
Soft tissue mass projects over the right lower abdomen. No bowel dilation. Source: Case courtesy of Dr Eric F Greif, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/29373">rID: 29373</a>
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.