Presentation
Intermittent abdominal pain with each episode lasting ~30 seconds. The patient would draw her legs up into her chest while screaming in pain. No reported episodes of emesis or blood in the stool. On physical exam, her abdomen was soft and not distended.
Patient Data
Within the right upper/mid abdomen, there is a target sign. There is trace adjacent free fluid
without a focal fluid collection or inflammatory changes.
There is an absence of bowel gas in the right upper quadrant. A mass-like structure is seen in the right upper quadrant, likely secondary to the patient's known intussusception.
Selected images from an air enema.
Eventually, there was a reflux of air into the distal small bowel.
There are multiple air-filled bowel loops without bowel wall thickening, inflammatory changes, free fluid, a focal fluid collection, or residual ileocolic intussusception.
Case Discussion
This is a case of an ileocolic intussusception.
The patient presented with intermittent abdominal pain. Ultrasound initially showed a small bowel to small bowel intussusception (not shown) so no action was indicated. The pain eventually subsided and the patient was discharged home.
However, the patient returned with abdominal pain where an ultrasound showed findings consistent with an ileocolic intussusception. The patient was taken to fluoroscopy for an air enema where there was successful reduction of the ileocolic intussusception. There were no recurrences of the intussusception.
Co-author:
Yostina Soliman
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