Cases/PediatricsGastrointestinal
Case 1016

Ileocolic intussusceptionWhat is the diagnosis?

Case image 1 Ultrasound 1 / 1

Transverse ultrasound of the right abdomen.

Image: Frank Gaillard, CC BY-SA 3.0 — source

Answer hidden. Review the images and history, decide on your diagnosis, then reveal.

Findings

  • A round mass of concentric rings of bowel wall — the target or doughnut sign
  • Bowel within bowel, with echogenic mesenteric fat drawn into the centre

Case discussion

The target sign on ultrasound in a young child with intermittent colicky pain is diagnostic of intussusception. Ultrasound is the test of choice and is highly sensitive.

Most cases in children are idiopathic and ileocolic, and are reduced by an image-guided air or fluid enema. Peritonitis, perforation or a failed reduction need surgery.

Encyclopedia

IntussusceptionTelescoping of one segment of bowel into the next, most often ileocolic in infants, causing obstruction and risk of ischaemia.

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