Presentation
Patient presented with excesssive crying and irritability.
Patient Data
During an abdominal scan, there were telescoping bowel loops in the right upper quadrant of the abdomen, giving the target sign when viewed transversely.
It was large in diameter (about 2.5 cm) with an internal fatty core and core-to-wall index of about 2.6, suggesting an ileocolic intussusception.
An ileal loop was contained along with a fatty core inside the cecum.
Enema reduction was requested, continue with the next study below.
At the start of the exam, the contrast flowed freely without delay or cut off till the right upper quadrant, where a central filling defect appeared giving the target sign (when viewed end on or meniscus sign when viewed from the side) confirming the ultrasound findings of ileocolic intussusception.
After two successful trials of reduction, the cecum was completely filled with contrast with a mild amount of contrast reflux into the terminal ileum indicating successful reduction.
Case Discussion
Intussusception is the common cause of intermittent abdominal pain in children with ileocolic intussusception is the most common documented type.
It is usually managed by enema reduction using various techniques, the hydrostatic-reduction under fluoroscopic guidance is the one of choice in our case.
Make sure that there are no signs of peritonitis or perforation before attempting an enema reduction.
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