Fact-sheet: Intussusception
Updated on 09/17/2021 at 12:16 PM
View all RADEOS cases associated with this fact-sheet
Definition
= intestinal intussusception.
Telescoping or folding of a bowel segment onto itself.
Generally idiopathic between 3 months and 3 years of age.
After age 3, an underlying cause should be suspected:
- tumor (adenocarcinoma, lymphoma, melanoma metastasis, lipoma, cecal endometrioma, polyp)
- inflammatory pseudotumor
- postoperative
- Meckel's diverticulum
- infectious (CMV, HIV).
Clinical features
Paroxysmal pain occurring in bouts.
Rectal bleeding.
Bowel obstruction.
Vomiting.
Neurologic forms: marked hypotonia.
Chronic forms: palpable mass.
Transient forms (celiac disease)
Radiography
Bowel obstruction.
Displacement of the cecal pole.
Reduction with hydrosoluble contrast or air enema: reflux into the ileal loops
Ultrasound
Target sign on axial images.
Possible crescent of fluid at the head of the intussusceptum.
Allows topographic diagnosis and measurement of the intussusception.
Peritoneal effusion
CT
Target appearance.
Shows the entrapment of the mesentery within the intussusception.
Upstream bowel obstruction.
May show the underlying cause in secondary forms
Management
Follow-up ultrasound 24 hours after reduction to rule out recurrence