Recurrent intussusception - diagnosis and reduction

Case contributed by Yaïr Glick

Presentation

Vomiting, abdominal pain, crying spells alternating with lethargy. Last bowel movement 48 hours ago.

Patient Data

Age: 10 months
Gender: Female

Abundant non-enlarged mesenteric lymph nodes.
Intussusception in right abdomen at level of umbilicus, with appearance of ileocolic intussusception. Mesenteric fat with several lymph nodes inside intussuscipiens, in addition to bowel.

The intussusception was seen as a filling defect at air enema reduction and indeed shown to be ileocolic. Reduction achieved on first try.

6 weeks later, presents with similar symptoms: vomiting and crying spells alternating with lethargy.

Ileocolic intussusception in same location as previous.
Normal vascular flow demonstrated in wall of Intussuscepted bowel.

Air enema reduction under fluoroscopy

Fluoroscopy

Under sedation, tube inserted into rectum and air insufflation commenced.
Ileocolic intussusception identified and reduced on first try, manifesting as retrograde passage of air into the small bowel.
Of note, feces in hepatic flexure.

Case Discussion

A case of recurrent ileocolic intussusception.

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