Interloop fluid in intussusception: what is its significance?

Interloop fluid in intussusception: what is its significance?,10.1007/s00247-010-1931-0,Pediatric Radiology,Robyn D. Gartner,Terry L. Levin,Steven H.

Interloop fluid in intussusception: what is its significance?  
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Background  Sonography has been used to predict pneumatic reduction outcome in children with intussusception. Objective  To assess the prognostic significance of fluid between the intussusceptum and intussuscepiens with respect to reduction outcome, lead point or necrosis. Materials and methods  Sonograms of children with a discharge diagnosis of intussusception from four institutions were reviewed for interloop fluid and correlated with results of pneumatic reduction and surgical/pathological findings when available. Maximal dimension of interloop fluid on a transverse image and fluid complexity were evaluated. Results  Of 166 cases, 36 (21.7%) had interloop fluid. Pneumatic reduction was successful in 21 (58.3%) with fluid and 113 (87.6%) without. The average largest fluid dimension was 8.7 mm (range 5 mm–19 mm, median 8 mm) in cases with successful reduction and 12.8 mm (range 4 mm–26 mm, median 12.5 mm) in unsuccessful reduction (p p < 0.0001;odds ratio13:1). In 36 cases with interloop fluid that required surgery, there were four lead points and three necrosis. In cases without fluid with surgical reduction, there was one lead point and one necrosis. Interloop fluid correlated with lead point (p p p p = 0.9). Conclusion  Interloop fluid was associated with increased failure of pneumatic reduction and increased likelihood of lead point or necrosis, particularly when the maximum dimension exceeded 9mm.
Journal: Pediatric Radiology - PEDIAT RADIOL , vol. 41, no. 6, pp. 727-731, 2011
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