In large bowel intussusceptions, several reports described US signs which are associated with a lower likelihood of reducibility by hydrostatic or pneumatic enema. US may demonstrate echogenic dots or lines (foci) in the bowel wall, which may indicate ischemic bowel.
To determine the presence of echogenic intramural and subserosal foci and trapped gas in large bowel intussusceptions and to correlate with the reducibility.
Material and methods
Between 2001 and 2008, 74 consecutive US examinations of large bowel intussusception were retrospectively evaluated by 2 pediatric radiologists for intramural, subserosal echogenic foci (gas) or trapped gas in the intussusception. The sonographic findings were correlated with the hydrostatic or pneumatic reducibility.
In 73 US examinations with large bowel intussusception, 56 (76%) were reducible and 17 (23%) were not reducible. Eight out of ten (80%) patients with intramural gas, six out of eleven (56%) with subserosal gas and nine out of fourteen (64%) with intramural and/or subserosal gas had non reducible intussusceptions. Univariate analysis of the above predictors found intramural gas and/or subserosal gas significantly influential. Multivariate analysis however proved only intramural gas to be the significant predictor, in presence of subserosal gas, of fluoroscopic reducibility
Having sonographically detected intramural gas in large bowel intussusception, significantly decreases the chance of intussusception reduction