Presentation
History of blood in stool for last one day.
Patient Data
The subhepatic region shows a herniation of lymph node, terminal ileum, and appendix into the colon. The outer wall shows edema. Color Doppler shows flow signals in the outer wall.
There is no ascites/ dilatation of proximal bowel loops.
Case Discussion
A child presented with a history of blood in stool. Ultrasound shows signs of ileocolic type intussusception. Fluoroscopically guided enema therapy failed and laparoscopy was done. Surgery confirmed the type of ileocolic and it was reduced. There was no bowel perforation.
Most of the intussusception cases show a mass in the subhepatic region as the ileocolic is the commonest type.
The axial ultrasound scan shows multiple concentric sign/ crescent-in-doughnut sign. The long axis scan shows the sandwich sign and hayfork sign 1.
The ultrasound findings of the mesenteric fat core diameter larger than the outer wall thickness, the larger diameter of the intussusception mass, presence of the lymph nodes in the intussusception favor ileocolic over small bowel intussusception 2.