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Diagnostic Accuracy of Abdominal Ultrasound in Pediatric Patients with Signs and Symptoms of Intussusception

In brief

Abdominal ultrasound achieved 100% positive predictive value for intussusception

In a review of 150 children under three years with suspected intussusception, ultrasound correctly identified all 36 confirmed cases, giving a 100% positive predictive value. The finding reinforces ultrasound as the preferred first-line test, but the study's retrospective design and lack of a reference standard for negative scans limit assessment of overall accuracy.

Journal
Medical principles and practice : international journal of the Kuwait University, Health Science Centre (Q1)
Published
22 September 2026
Study design
Retrospective cohort
Evidence level
Level 3, Low (CEBM 3b)
Authors
Atef Ali Hamdan Khattab, Mohamed Sherif Mohamed El-Sharkawy, Abdullah Mohammad Ali Khattab, Abdelrahman Nihad Ahmad Barakat, Abdelrahman Abdallah Mahmoud Almasri, Fahad Amin Al Atawi
PMID
42771560
DOI
10.1159/mpp/adpag026

Why clinicians should know about it

  • Picked for Pediatrics and Child Health (paper of the day, 27 September 2026): Positive predictive value of ultrasound for intussusception

Abstract

OBJECTIVE: To evaluate the diagnostic performance of abdominal ultrasonography, specifically its positive predictive value, in children younger than 36 months presenting with suspected intussusception to the emergency department of a major tertiary care center in Saudi Arabia, and to describe the associated clinical and sonographic features. METHODS: This retrospective study reviewed the medical records and radiological findings of 150 pediatric patients aged less than 36 months who presented with suspected intussusception to the emergency department in a major tertiary care center in Saudi Arabia between 2005 and 2015. Ultrasound was used as the initial diagnostic modality, and findings were confirmed using contrast enema, computed tomography scan, or intraoperative findings when applicable. RESULTS: Out of 150 suspected cases, 36 patients(24.0%) were confirmed to have intussusception. All 36 ultrasound-positive cases were subsequently confirmed by contrast enema, computed tomography, or surgery, giving a positive predictive value of 100% (36/36). Because the 114 ultrasound-negative patients were classified on the basis of clinical course rather than an independent reference standard, sensitivity, specificity, and negative predictive value could not be validly estimated and are not reported. Vomiting and bloody stool were significantly associated with confirmed diagnosis; no significant association was found with gender. CONCLUSION: In this single-center retrospective cohort, a positive abdominal ultrasound reliably predicted confirmed intussusception, supporting its established role as the first-line imaging modality for suspected pediatric intussusception. Although this regional data add local confirmation but, given the retrospective design and the absence of an independent reference standard for ultrasound-negative cases, it should be interpreted with caution.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.