Intussusception (transient, small bowel)

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

USG referred for abdominal pain. Two different cases 55 years Female 12 years Boy

Mentioned in case discussion

Mentioned in case discussion

Case Discussion

Case I -- 55 yrs old female. Pain in abdomen 2 wks.

USG - Left lumbar region Target appearance. It occurred over a short segment (3 cm). No mass lesion seen. Proximal bowel loop showed thickened wall (7 mm). Proximal bowel loops distended with fluid (15 mm) but not dilated.

CT (images not available) done after 6 -7 hrs. No target appearence. Single left sided small bowel loop showed odema with hyperattenuation - ? Hemorrhage. USG repeated at that center. No target appearence.

Small bowel intussusception less than 3 cm long, without lead point, without proximal dilated loops and with normal peristalsis of proximal loops. These are transient. So follow up after few hrs is suggested.

CASE II - 12 yrs boy. Episodic abdominal pain - 10 days. Intussusception was noted on left side of umbilicus. After documentation was done on grayscale, the intussusception disappeared. When patient walked in for USG, there was pain, but the pain disappeared with resolution of the intussusception. No signs of obstruction / peritonitits / lead point / wall odema was noted.

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