Cosme-Labarthe JE, Sangri-Pinto G, Sánchez-Sánchez JM, Roldán-Valadez E

Language: Spanish
References: 16
Page: 64-68
PDF size: 99.50 Kb.

ABSTRACT

The intussusception is the invagination of the small or large bowel (intussusceptum) in the distal contiguous segment of the intestine (intussuscipiens). The mechanical consequences of the invagination are obstruction and ischemia. Approximately 90% of the invaginations are ileocecal; the rest are ileocolic, ileoileal and colocolic. We present the case of a two-years old female patient referred from the Pediatrics service to the Radiology department, she had complained from colicky intermittent painful crises in right iliac fossa for the last 13 hours. An appendicular-region ultrasound was performed, it showed the invagination, in view of this finding the hydrostatic reduction of the invagination was attempted using a barium enema. The invagination was successfully reduced. We presented a brief description of the main imaging findings in this clinical entity by using plain films, ultrasound and barium enema. The suspicion of intestinal invagination constitutes an emergency. The consultation with the department of surgery is imperative, not only in doing the diagnosis, but also in making the decision whether the management starts with hydrostatic reduction using a barium enema or if the patient is taken to operation room for surgical treatment. The children with suspicion of invagination must undergo radiological examination only when they are hemodynamically stable. They must be accompanied by trained personnel in case some decompensation takes place.

REFERENCES

1. Buonomo C, Taylor GA, Share JC, Kirks DR. Tracto gastrointestinal. En: Kirks DR, ed. Radiología pediátrica. Madrid, España: Marban Libros, S.L.; 2000; Vol. 2: 910-922.

2. De Castro CC, Pérez L, Castro CAR. Radiología gastrointestinal pediátrica. En: Stoopen ME, Kimura K, Ros PR, eds. Abdomen. El tubo digestivo. 1a. ed. Philadelphia, PA.: Lippincott Williams & Wilkins; 1999; Vol. 1: 320-323.

3. Del-Pozo G, Albillos JC, Tejedor D. Intussusception: US findings with pathologic correlation—the crescent-in-doughnut sign. Radiology 1996; 199(3): 688-92.

4. Lim HK, Bae SH, Lee KH, Seo GS, Yoon GS. Assessment of reducibility of ileocolic intussusception in children: usefulness of color Doppler sonography. Radiology 1994; 191(3): 781-5.

5. Wilson SR. Tracto gastrointestinal. In: Rumack CM, Wilson SR, Charboneau JW, eds. Diagnóstico por ecografía. Madrid, España: Marban Libros, S.L.; 1999; Vol. 1.: 310-311.

6. Parienty RA, Lepreux JF, Gruson B. Sonographic and CT features of ileocolic intussusception. AJR Am J Roentgenol 1981; 136(3): 608-10.

7. Weissberg DL, Scheible W, Leopold GR. Ultrasonographic appearance of adult intussusception. Radiology 1977; 124(3): 791-2.

8. Kirks DR. Air intussusception reduction: «the winds of change ». Pediatr Radiol 1995; 25(2): 89-91.

9. Poznanski AK. Why I still use barium for intussusception. Pediatr Radiol 1995; 25(2): 92-3.

10. 10.Connolly B, Alton DJ, Ein SH, Daneman A. Partially reduced intussusception: when are repeated delayed reduction attempts appropriate? Pediatr Radiol 1995; 25(2): 104-7.

11. 11.Swischuk LE, Stansberry SD. Ultrasonographic detection of free peritoneal fluid in uncomplicated intussusception. Pediatr Radiol 1991; 21(5): 350-1.

12. 12.Feinstein KA, Myers M, Fernbach SK, Bhisitkul DM. Peritoneal fluid in children with intussusception: its sonographic detection and relationship to successful reduction. Abdom Imaging 1993; 18(3): 277-9.

13. 13.Lam AH, Firman K. Value of sonography including color Doppler in the diagnosis and management of long standing intussusception. Pediatr Radiol 1992; 22(2): 112-4.

14. 14.Stephenson CA, Seibert JJ, Strain JD, Glasier CM, Leithiser RE Jr, Iqbal V. Intussusception: clinical and radiographic factors influencing reducibility. Pediatr Radiol 1989; 20(1-2): 57-60.

15. 15.Katz M, Phelan E, Carlin JB, Beasley SW. Gas enema for the reduction of intussusception: relationship between clinical signs and symptoms and outcome. AJR Am J Roentgenol 1993; 160(2): 363-6.

16. 16.Rohrschneider WK, Troger J. Hydrostatic reduction of intussusception under US guidance. Pediatr Radiol 1995; 25(7): 530-4.