Ultrasound images of Intussusception pediatric

Intussusception is the invagination of a segment of bowel into the lumen of the adjacent bowel. It is a common paediatric emergency, especially in younger children aged 3 months to 3 years, and tends to affect the ileocaecal region. The child presents with abdominal pain, sometimes with a palpable mass, vomiting or rectal bleeding. Intussusception can result in bowel necrosis and subsequently perforation requiring surgery. The ultrasound appearances of bowel within bowel are characteristic. In cross-section, the bowel assumes a ‘doughnut’ configuration, with concentric rings of bowel wall (Fig. ultrasound images below).

The characteristic appearance of bowel within bowel due to an intussusception.

Dilated loops of fluid-filled obstructed bowel may be demonstrated proximal to the intussusception. The use of ultrasound to diagnose this condition is highly reliable, reducing or eliminating the need for contrast radiology. An air enema is most commonly used to reduce the intussusception using inflation pressures of up to 120 mmHg. Hydrostatic reduction (that is, with water/saline) under fluoroscopic or ultrasound control is also an accepted treatment.

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