Diagnostic Accuracy of Point-of-Care Ultrasound for Intussusception in Children Presenting to the Emergency Department: A Systematic Review and Meta-analysis

Abstract

Introduction: Ileocolic intussusception is a common cause of pediatric bowel obstruction in young children but can be difficult to diagnose clinically due to vague abdominal complaints. If left untreated, it may cause significant morbidity. Point-of-care ultrasound (POCUS) is a rapid, bedside method of assessment that may potentially aid in the diagnosis of intussusception. The purpose of this systematic review and meta-analysis was to determine the diagnostic accuracy of POCUS for children with suspected ileocolic intussusception by emergency physicians (EP). Methods: We conducted a systematic search on PubMed, Embase, CINAHL, LILACS, the Cochrane databases, Google Scholar, as well as conference abstracts, and assessed bibliographies of selected articles for all studies evaluating the accuracy of POCUS for the diagnosis of intussusception in children. We dual extracted data into a predefined worksheet and performed quality analysis with the QUADAS-2 tool. Data were summarized and a meta-analysis was performed. Results: Six studies (n = 1303 children) met our inclusion criteria. Overall, 11.9% of children had intussusception. POCUS was 94.9% (95% confidence interval [CI], 89.9% to 97.5%) sensitive and 99.1% (95% CI, 94.7% to 99.8%) specific with a likelihood ratio (LR)+ of 105 (95% CI, 18 to 625) and a LR− of 0.05 (95% CI, 0.03 to 0.10). Conclusion: POCUS by EPs is highly sensitive and specific for the identification of intussusception for children presenting to the emergency department.