Ileocolic intussusception

Case contributed by T Menezes
Diagnosis probable

Presentation

Multiple episodes of vomiting and diarrhea.

Patient Data

Age: 8 months
Gender: Female
ultrasound

A 4 cm mass in the left upper quadrant with pseudokidney sign. 

Transverse image shows round mass with alternating concentric rings of hyper- and hypoechogenicity representing bowel wall and mesenteric fat.

Longitudinal image shows a mass that has a reniform appearance, with a central hyperechoic region surrounded by a hypoechoic region. 

Case Discussion

Intussusception is described as a portion of the intestine that telescopes into a more distal intestinal segment. It is a common abdominal emergency in children and one of the most common causes of abdominal obstruction in infants. 

The most common type of intussusception is ileocolic/ileocecal) (90%). The most common location of idiopathic intussusception is at the hepatic flexure. 

Ultrasound signs include the target sign and pseudokidney sign.

Air enema is now considered the gold standard treatment of intussusception in children. Surgical intervention is needed only in unstable patients with non-operative reduction contraindications or in prior unsuccessful reduction attempts.

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