Peridictive Accuracy of Absent Color Flow on Doppler Ultrasound in the Operative Finding of Intussusception at Tikur Anbessa Specialized Hospital,Ethiopia
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Date
2023-10
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Addis Ababa University
Abstract
Background: Intussusception is a common paediatric surgical emergency condition which has
contributed a significant burden on morbidity, mortality, and emergency surgical health care.
Despite ultrasound serving a great deal as an accurate tool in diagnosing intussusception,
evidences on the diagnostic accuracy of absent colour flow with the intraoperative finding are
limited. The aim of the study was to assess the diagnostic accuracy of absent flow on colour
Doppler Ultrasound study with intraoperative findings of Intussusception
Methods: Hospital based retrospective crossectional study was used. The medical record number
of patients operated in the past 5 years, from September 2017-December 2022, with the
preoperative diagnosis of intussusception, was traced and their charts were retrieved. The data
was collected with standardised questionnaire. The data was cleaned, entered and analyzed using
SPSS version 25. Diagnostic accuracy of absent color flow to predict gangrenous and viable
bowel was measured using Sensitivity, specificity, positive predictive value (PPV), and negative
predictive value (NPV). Uni-variate analysis was performed to test factors associated with
gangrenous intussusception. A binary logistic regression mode was used to identify independent
risk factors. Results of logistic regression reported as adjusted odds rations (OR) with 90%
confidence intervals.
Results: During this crossectional study, data from 121 patients were collected. The median age
was 9 months (±IQR 9) with male predominance (70.2%). The most common complaints were
vomiting (93.4%), non-bloody Diarrhea (78.5%), abdominal pain (89.3%), fever (29.7%),
abdominal distension (14%) and, bloody diarrhea (8.3%). while the commonest physical findings
were currant jelly stool detected at the time of DRE (62.8%), palpable abdominal mass (45.5%),
abdominal distension (41.3%). Classic triads were present in 35.5% of the patients. The
postoperative complication rate was 20.7% and mortality rate was 2.5%.
Conclusion: In our setting Color Doppler US had Sensitivity of 46.8%, Specificity of 84.3%,
PPV of 66.67% and NPV of 70.2% in predicting whether or not an intussuscepted bowel is
gangrenous.
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Keywords
Paediatric gangrenous Intussusception, Outcome, Doppler US