Fluoroscopic guided reduction of colocolonic intussusception

Case contributed by Mohamed El Deen


1 year old baby boy with intermittent crying. Rectal examination showed jelly like material.

Patient Data

Age: 1 years
Gender: Male

Single contrast fluoroscopic guided successful reduction of colo-colonic intussusception done without any complications.

We noted that rotating the child gently in both oblique sides on the table during the procedure accelerated the reduction of the intussusception.

The second image shows Claw signs, pathognomonic for gut telescoping of intussusception.

Case Discussion

Intussusception is a mechanical telescoping of bowel segment into other. The most common site is at ileocecal junction, the second most common site is colocolonic.

Sometimes enlarged lymphoid tissue is the underlying cause of this pathology which was detected on a previous ultrasound that is not available at the time of the study.

Immediate reduction by fluoroscopic guided enema using air or contrast will cause immediate relief and reduction of the telescoping. Air enema is considered safer than barium enema.  We used OmnipaqueTM 300 50/50 mixed with saline during this study.

The child was discharged immediately after the procedure.  There was no recurrence in follow up visits.

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