Ileocolic intussusception

Case contributed by Dr Neil Lall

Presentation

Abdominal pain and vomiting beginning approximately 4 hours prior to initial imaging.

Patient Data

Age: 20 months
Gender: Male
CT

CT performed at outside hospital demonstrated ileocolic intussusception extending to the right upper quadrant.

Ultrasound

Target sign in the right upper quadrant transverse colon verified continued presence of intussusception after patient transfer

Fluoroscopy

Water soluble contrast enema reduction of intussusception

Case Discussion

The patient's vague clinical presentation at the outside hospital triggered evaluation with CT rather than the typical workup of ultrasound. Approximately 5 hours later when the patient arrived, ultrasound confirmed continued presence of the intussusception and preserved vascularity. Immediately after ultrasound, the patient was taken for enema reduction, which was successful on the second attempt. (The intussusception easily reduced to the level of the ileocecal valve initially but would not easily reflux on the first attempt, as commonly happens.)

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Case information

rID: 55217
Case created: 25th Aug 2017
Last edited: 3rd Oct 2017
Inclusion in quiz mode: Included

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