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Abdomen » Gastrointestinal
Intussusception
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Author(s) :
Ravi Kadasne, MD
 
Presentation A 3 year old female child presented with an acute episode of severe pain in the abdomen. An ultrasound was performed immediately.
 
 
 
Caption: Transverse view of the right hypochondrium
Description: This image clearly depicts the crescent sign and the doughnut sign, typical of intussusception.
 
 
 
Caption: Sagittal view at the site of pain
Description: A portion of the bowel [hypoechoic] and its mesentery [brightly echogenic] is seen telescoping into another segment of the bowel [delineated by arrows].
 
Differential Diagnosis Intussusception

 
Final Diagnosis Intussusception
 
Discussion This case illustrates the classical ultrasound signs of intussusception. On transverse sections, a swirling pattern of alternating layers of hyper and hypo-echogenic bowel wall layers is noted.  On the sagittal section, a sandwich like appearance of alternating loops of bowel is noted.

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Case References 1. Woods, B. Intussusception, child. http://www.emedicine.com/radio/topic366.htm#section~pictures
 
Follow Up This child had spontaneous resolution of pain 20 minutes after the scan was performed. A follow up ultrasound showed complete resolution of the intussusception.