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Sonographic Detection of Lymph Nodes in the Intussusception of Infants and Young Children

Clinical Evaluation and Hydrostatic Reduction

¹ Department of Radiology, "Agia Sofia" Children's Hospital, Thivon and Mikras Asias Sts., Goudi, 11527 Athens, Greece.
² First Department of Pediatric Surgery, "Agia Sofia" Children's Hospital, 11527 Athens, Greece.
³ Department of Anatomy-Embryology, University of Crete Medical School, P.O. Box 1393, Herakleion, 711 10 Crete, Greece.

OBJECTIVE. Our aim was to assess the sonographic appearance of enlarged lymph nodes in the intussusception in infants and young children and to investigate whether the enlarged lymph nodes affect the hydrostatic reduction rate of intussusception.

MATERIALS AND METHODS. This retrospective case control study included a total of 65 children with intussusception, consisting of two groups: a study group of 28 patients with lymph nodes detected in intussusception and a reference group of 37 patients of similar age without lymph nodes in intussusception. The selection criterion for the study group was the presence of a minimum of two lymph nodes, of which at least one had a long axis of 11 mm or greater. The intussusception patterns, target or doughnutlike, and the presence of trapped fluid in the intussusception were also evaluated. Clinical records were reviewed for associated disease. The reducibility of both study and reference groups was assessed and correlated with all the sonographic features mentioned.

RESULTS. Twenty-two of the 28 patients in the study group and none in the reference group had a recent or a current history of gastroenteritis. The overall hydrostatic reduction rate was 46.4% in patients with enlarged lymph nodes in the intussusception and 81.1% (p < 0.005) in patients without enlarged lymph nodes in the intussusception. Larger rather than numerous lymph nodes significantly affected the reducibility rate. Most of the reference group patients had a hydrostatic reduction at first attempt, whereas a second attempt at hydrostatic reduction was required in most of the study group patients.

CONCLUSION. Enlarged lymph nodes in the intussusception are mainly found in patients with a current or recent history of gastroenteritis and decrease the overall hydrostatic reduction rate.

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