Ileocecal intussusception

Case contributed by Dr Amir Mahmud

Presentation

Patient presented with pain in the right iliac fossa, radiating to the periumbilical region. On examination, a fixed and tender mass was palpable over the right iliac fossa.

Patient Data

Age: 50 years
Gender: Male
CT

There is pulling of the terminal ileum into the cecum most evident on the axial set of images in the right iliac fossa, with a resultant homogenously dense rounded mass also seen in the superficial aspect, adjacent to the anterior abdominal wall. 

Annotated image

This is re-demonstrated on the coronal and sagittal planes, where a bowel within bowel appearance forming concentric rings (better known as the 'target sign') is also seen, which is a classical appearance in keeping with intussusception.

Case Discussion

Ileocecal intussusception is relatively rare when compared with other types of bowel intussusception, and usually occurs secondary to a lead point in the cecum, ileum or appendix such as a lipoma, inflammatory or hamartomatous polyps, bowel carcinoma, lymphoma or even a Meckel diverticulum. Periappendiceal mucoceles or local inflammatory processes may also cause this.

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Case information

rID: 82203
Published: 12th Nov 2020
Last edited: 23rd Nov 2020
Inclusion in quiz mode: Included
Institution: Private diagnostic centre

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