Predictive value of radiological and clinical findings in early diagnosis of invagination

Introduction: Invagination is the most common cause of acute abdomen and the
second common cause of intestinal obstruction in the children under the age of two
years, and the delay in diagnosis and treatment can be dangerous and even fatal. The
aim of this study is to estimate the exact value of the diagnostic clinical and
radiological findings in order to speed up the diagnosis of this emergency issue.
Methods: This cross-sectional study was performed on 160 patients diagnosed
with invagination. After collecting the data ,sensitivity, specificity and the
positive and negative predictive values of clinical and radiological findings were
calculated using SPSS software.
Results: 63.1% of the patients were boys and most of cases were 10-50 months
old. In 21.9% of the patients, three major clinical findings (triad) existed
simultaneously: colicky abdominal pain, abdominal mass, currant-jelly stool.
Ultrasonography and barium enema had the diagnostic sensitivity of: 69.3, 87.9,
91.4, 83.3 and 94.4 percent, specificity of 20, 39.2, 45.6, 27.7 and 88.9 percent,
positive predictive value of 85.8, 45.1, 56.6, 87.6, and 97.1 percent, and also
negative predictive value of 8.5, 85.1, 87.2, 65.3 and 80 percent, respectively.
Conclusion: Our study showed that in contrast to other world centers, the usage
of barium enema was more frequent and of less curative value. Futhermore, in
this study ultrasonography has not been used for all patients and its diagnostic
value has been less than barium enema. Considering the important role of
ultrasonography in diagnosing and treating the disease in recent years, training
residents and specialists of radiology and even other specialities of medicine
(such as pediatrics and surgery) is a necessity.