Keywords:
Obstruction / Occlusion, Acute, Surgery, Audit and standards, CT, Small bowel, Gastrointestinal tract, Abdomen
Authors:
C. H. H. Little1, C. M. Cameron2, M. A. Hunter2; 1Glasgow, Glasgow/UK, 2Glasgow/UK
DOI:
10.26044/ecr2019/C-2283
Aims and objectives
The detection of intussusception is increasing both with technological advancements in multi-detector CT and with its increasing use in abdominal imaging.
In particular,
there have been increasing numbers of non-lead point intussusceptions that may be transient and therefore not require surgical intervention [1].
Determining the clinical significance of such a finding can be a diagnostic challenge.
Intussusception has a classic bowel within bowel appearance on CT with invagination of a segment of the gastrointestinal tract (intussusceptum) into an adjacent segment (intussuscipiens).
The mesentery and mesenteric vessels are also invaginated giving a multi-layered appearance [2].
Further findings on imaging such as the identification of a lead-point,
the location and length of the intussusception and associated complications such as ischaemia or obstruction may aid in the differentiation of intussusception requiring urgent surgical intervention and transient,
incidental intussusception.
This may guide surgical management with the possibility of reducing unnecessary surgery and its associated complications.
Therefore,
the primary aims of this study were to identify how often a lead point was accurately identified on CT using operative and pathological findings as a reference standard and to assess the incidence of incidental intussusception without lead point.
The secondary aims were to assess whether we can predict these non-surgical intussusceptions based on CT characteristics.