Ileoileal intussusception in children: ultrasonographic differentiation from ileocolic intussusception

Background: The treatment of ileoileal intussusception in children differs from that of ileocolic intussusception. Objective: To differentiate ileoileal intussusception from ileocolic intussusception using ultrasonography. Materials and methods: We reviewed the clinical and ultrasonographic findings in 27 patients with intussusception between September 2003 and July 2005. For statistical analysis the Mann-Whitney test was applied. Results: Regarding ileoileal intussusceptions, 11 were documented in ten patients (seven boys, three girls; mean age 3.1 years). Symptoms suggestive of intussusception were present in nine patients. The mean diameter was 1.5 cm (range 1.1-2.5 cm) and length 2.5 cm (range 1.5-6.0 cm). The intussusceptions were located in the paraumbilical region (n=6), the right upper quadrant (n=2), the right lower quadrant (n=2), and the left lower quadrant (n=1). Regarding ileocolic intussusceptions, 16 were documented in 14 patients (13 boys, 1 girl; mean age 1.9 years). All patients had symptoms suggestive of intussusception. The mean diameter was 3.7 cm (range 3.0-5.5 cm) and mean length was 8.2 cm (range 5.0-12.5 cm). All intussusceptions were located in the right side of the abdomen. The difference in diameter and length between ileoileal and ileocolic intussusceptions was statistically significant (P < 0.05). Conclusion: Unlike clinical symptoms, ultrasonography can differentiate between ileoileal and ileocolic intussusception. The diameter and length of the intussusception are the main criteria.