Intussusception

Case contributed by Dr Subash Thapa

Presentation

Acute pain abdomen with vomiting.

Patient Data

Age: 7 years
Gender: Male
Ultrasound

There is soft tissue mass with a concentric alternating hyperechoic and hypoechoic bands resembling target appearance. The fat containing mesentery is dragged into the loop of bowel with “pseudokidney sign”. There are also multiple enlarged mesenteric lymph nodes.

Case Discussion

Telescoping of the proximal bowel loop (intussusceptum) distally into to the distal loop (intussuscipiens) is called intussusception.

Intussusceptum can be small bowel within small bowel or small bowel within colon or colon within the colon or vice versa (jejunogastric or gastro-jejunal in case of post gastrojejunal anastomoses) 1.

Intussusception is promoted by polypoidal benign neoplasms (lipoma, adenoma) or malignant mass (lymphoma, carcinomas) or enlarged lymphoid tissues following an infection or even a worm 1.

Ileocolic or colocolonic intussusceptions are usually treated with air or contrast enema in children. However, surgery may be the choice to disengage the bowel from itself.

 

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