intussusception
Post on 24-May-2015
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Intussusception
Dr/ Hytham Nafady
Definition
• Telescoping invagination of an intestinal segment into the lumen of a proximal segment.
Intussuscpetion
Without a leading point With a leading point
ESENTERY
Lymphoid hyperplasia
EtiologyAdults Children
Spontaneous: (without anatomical leading point):•Celiac disease.•Scleroderma.•Whipple disease.
Spontaneous: (without anatomical leading point) in 90% of cases:•Mucosal edema & lymphoid hyperplasia after viral gastroenteritis.
Leading point (90%):•Tumor:Usually benign in small intestine & malignant in large intestine.•Polyp,•Ulcer,•Foreign body.
Leading point:•Meckel’s diverticulum.•Polyp.•Enterogeneous cyst.•Ectopic pancreas.•Purpura.
C.PAdults Children (6M-2Y)
Recurrent abdominal pain.
Abrupt onset of violent crampy abdominal pain.
Vomiting.Bloody stool. Redcurrant jelly stool.
Palpable abdominal mass.
Palpable Abdominal mass.
Types
Adults Children Ileo-ileal.Ileo-colic.
Ileo-colic.Ileo-ileal.Colo-colic.
Redcurrant jelly stool
األحمر الكشمش
Plain x-ray abdomen
• May be normal.• Meniscus sign:• Crescent of gas within colonic lumen that
outlines the apex of intussusceptum.• Little air in small intestine.
Meniscus sign
Meniscus sign
U/S
• Target sign:
Barium enema
• Coil spring appearance:• Trapping of barium between the edematous
mucosal folds of the returning limb of intussusceptum & wall of intussuscepian.
• Meniscus sign:• Convex intraluminal mass.
The main contraindication of enema is perforation
Coil spring sign
Colo-colic intussusception with a leading point of adenocarcinoma
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