Clinical signs and symptoms associated with intussusception in young children undergoing ultrasound in the emergency room

OBJECTIVE: The purpose of this study was to evaluate all patients suspected of having intussusception and identify which signs and symptoms were associated with the disease. METHODS: We performed a retrospective review of 553 charts from 2006 to 2010 of patients'age 2 months to 5 years who had an abdominal ultrasound obtained to evaluate for intussusception. Charts were reviewed for signs and symptoms previously shown to be associated with intussusception. RESULTS: There were 452 patients (mean age, 21.5 months, 43% female) evaluated and 101 (22.3%) were found to have intussusception. Of the 18 signs and symptoms, crying (adjusted odds ratio [OR], 3.3; 95% confidence interval [95% CI], 1.3-8.1), abdominal mass (adjusted OR, 15.7; 95% CI, 4.4-55.3), pallor (adjusted OR, 6.5; 95% CI, 1.8-23.5), and vomiting (adjusted OR, 3.1; 95% CI, 1.4-6.5) were associated with disease confirmation in logistic regression analysis. The presence of all 4 clinical signs/symptoms together resulted in a 95% probability of intussusception. Intussusception was unlikely if all 4 clinical indicators were absent (probability = 1.6%). CONCLUSIONS: The presence of crying, abdominal mass, pallor, and vomiting were clinical indicators of intussusception. Individually, none of these variables were helpful in confirming the diagnosis but in the presence of all 4, there is a 95% probability of having the disease. The absence of all 4 of these made the likelihood of having the disease very low.