Pediatric intussusception

Case contributed by Chris Newman

Presentation

Recent upper respiratory tract infection. Now presents with generalized lower abdominal pain. ? Appendicitis

Patient Data

Age: 5 years
Gender: Female
ultrasound
  • the appendix is not identified
  • within the right iliac fossa, there is the appearance of a 'doughnut sign' in trans imaging characterized by concentric alternating echogenic and hypoechoic bands as well as a 'pseudokidney' sign in long images characterized by fat-containing mesentery dragged into the intussusception
  • the hyperechoic core (mesenteric fat) has a diameter exceeding that of the outer wall, which is suggestive of ileocolic intussusception
  • trace volume free fluid in the right iliac fossa
  • no lead point identified

Case Discussion

Intussusception is a relatively common cause of right iliac fossa pain in the pediatric population. 

This patient was transferred to a tertiary pediatric hospital for further evaluation and consideration of air-enema reduction.

The site of this intussusception was not known, however both statistical probability, location and some ultrasound features suggest it is an ileocolic intussusception.

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