Predicting bowel necrosis in pediatric acute intussusception using roundness and other related factors

Objective This study aimed to investigate the risk factors of intestinal necrosis in children with intussusception and intestinal necrosis was established. Methods The clinical data of children diagnosed with intestinal necrosis after surgical treatment in our hospital were retrospectively analyzed and assigned to the bowel necrosis group.A control group was established treated successfully with air enema, without bowel necrosis, during the same period. Ultrasonic manifestation and clinical features were recorded and analyzed. Factors associated with bowel necrosis were analyzed using univariate and multivariate unconditional logistic regression analyses. Results (1) The bowel necrosis group included a higher proportion of children under 12 months of age, and had more cases with blood flow signal < grade 4, peritoneal effusion, and bloody stools ( P < 0.05) than the non-intestinal necrosis group. The values for roundness, concentric ring thickness, length of the intussuscepted segment, head-to-neck diameter ratio, bowel wall thickness, and neutrophil-to-lymphocyte ratio ( NLR) were all higher in the bowel necrosis group ( P < 0.05). (2) The logistic regression analysis indicated that roundness (×100) [odds ratio ( OR ) = 1.397, 95% confidence interval ( CI ): 1.086–1.796] and blood flow signal (< grade 4) ( OR = 0.099, 95% CI : 0.018–0.543) were independent predictors of bowel necrosis in intussusception. Conclusions Roundness and blood flow signal grading are independent predictors for diagnosing bowel necrosis in pediatric intussusception.