Obscure Intussusception Diagnosed by Ultrasonography

Uhland, Hugo

doi:10.1001/jama.1978.03280300056023

Cited by 14 publications

(4 citation statements)

References 6 publications

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“…Early studies of the US appearance of intussusception reported a doughnut or pseudokidney appearance composed of a hypoechoic outer ring and a hyperechoic center. This appearance is similar to the US findings in other pathologic conditions of the gastrointestinal tract that cause thickening of the bowel wall (12,(36)(37)(38)(39). Appearances that are characteristic of intussusception have also been reported.…”

Section: S S S S S Diagnosis With Enema Examina-tionsupporting

confidence: 87%

Intussusception in Children: Current Concepts in Diagnosis and Enema Reduction

del-Pozo¹,

Albillos²,

Tejedor³

et al. 1999

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Intussusception cannot be reliably ruled out with clinical examination and plain radiography. However, a contrast material enema study and ultrasonography (US) allow definitive diagnosis of intussusception. The components of an intussusception produce characteristic appearances on US scans. These appearances include the multiple concentric ring sign and crescent-in-doughnut sign on axial scans and the sandwich sign and hayfork sign on longitudinal scans. Indicators of ischemia and irreducibility are trapped fluid at US and absence of blood flow at Doppler imaging. The aim of enema therapy is to reduce the greatest number of intussusceptions without producing perforation. Barium, water-soluble contrast media, water, electrolyte solutions, or air may be used with radiographic or US guidance. The differences in reduction and perforation rates between the various types of enemas are probably due more to perforations that occurred before enema therapy and the pressure exerted within the colon than to the contrast material used. The pressure within the colon is more constant with hydrostatic reduction than with air reduction; this fact may explain the lower risk of perforation with hydrostatic reduction. Radiation exposure is lower with air enema therapy than with barium enema therapy and is absent in US-guided enema therapy.

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Section: S S S S S Diagnosis With Enema Examina-tionsupporting

confidence: 87%

Intussusception in Children: Current Concepts in Diagnosis and Enema Reduction

del-Pozo¹,

Albillos²,

Tejedor³

et al. 1999

RadioGraphics

254

169

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“…Abdominal tenderness is present in almost all patients but a palpable mass is found in only one quarter (Stubenbord & Thorbjarnarson 1969) and abnormal bowel sounds are present in only one ultrasound would appear to offer the best hope of early diagnosis. The diagnosis of intussusception by ultrasound, describing 'single or double concentric rings of sonolucency surrounded by a course central echogenic focus' has been reported (Uhland & Parshley 1978;Morin et al 1981). In our patient, and also the one reported by Bourque & Gibbons (1979), ultrasound provided an early clue to the correct diagnosis but in both the findings were misinterpreted with resultant delay in treatment.…”

Section: Discussionsupporting

confidence: 48%

“…However, the clinical picture and X-ray findings associated with intussusception in adults are bizarre and a correct pre-operative diagnosis is rarely made (Cotlar & Cohn 1961). The diagnosis of intussusception by ultrasound, describing 'single or double concentric rings of sonolucency surrounded by a course central echogenic focus' has been reported (Uhland & Parshley 1978;Morin et al 1981). Vomiting is usually mild (Cotlar & Cohn 1961) and rectal bleeding is infrequent (Stubenbord & Thorbjarnarson 1969).…”

Section: Discussionmentioning

confidence: 99%

Intussusception in pregnancy. Case report and review of the literature

Watson

Quayle

1986

BJOG

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A 23-year-old woman was admitted to the obstetric ward at 37 weeks in her fourth pregnancy. She complained of colicky generalized abdominal pain and nausea for 6 h before her admission. The antenatal period had been uneventful. On examination the uterus was not tender, consistent with 37 weeks gestation, and a fetal heart beat was present. There was tenderness on palpation in the epigastrium and right hypochondrium, but there was no abdominal guarding and normal bowel sounds were present. Her pain settled but returned 48 h later with vomiting of bile-stained fluid. Biliary colic was diagnosed. A full blood count, plasma electrolytes and serum amylase were normal and a plain abdominal X-ray showed no abnormality. She was treated with intravenous fluids and again her symptoms quickly settled. Four days after admission an ultrasound examination was performed. This showed a normal gall bladder, liver and kidneys but also revealed an elliptical cystic mass extending from the renal angle into the right iliac fossa. The nature of the mass was uncertain but it was considered that it might be dilated loops of small bowel. The patient remained asymptomatic. A week after admission she developed a further recurrence of right sided upper abdominal pain and vomiting. At the time she also reported reduced fetal movements. Cardiototography showed diminished baseline variability and reduced fetal movements. Because of the abnormal fetal heart trace, labour was induced and 1 h later, at only

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“…The earliest descriptions of a target-like or a bull's eye appearance on transverse section, i.e. a sonolucent periphery with a larger echogenic centre (3,13,16,18) turned out to be non-specific, being common to most masses arising from the gastrointestinal tract. HOLT & SAMUEL (7) first described an ultrasonographic pattern which appeared to be pathognomonic of intussusception: double anechoic concentric rings surrounding a rough central echogenic area seen on transverse scans.…”

Section: Discussionmentioning

confidence: 99%

Ileocolic Intussusception in Large Cell Lymphoma of the Terminal Ileum

Greco¹,

Leung²,

Zwi³

et al. 1986

Acta Radiologica. Diagnosis

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A case of an adult patient with ileocolic intussusception secondary to a lymphoma of the terminal ileum is reported. On the computed tomograms, a target mass, with the outer rim representing the annular tumour of the terminal ileum and the eccentric rim of low attenuation representing the mesentery, is described. Ultrasound patterns are those of parallel hypoechoic areas separated by hyperechoic stripes seen on longitudinal sections, and of a rounded mass of low echogenicity, exhibiting two hyperechoic concentric ring-like areas within it, on transverse scans. The appearances of the barium examinations are also described. The English literature is reviewed.

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Obscure Intussusception Diagnosed by Ultrasonography

Cited by 14 publications

References 6 publications

Intussusception in Children: Current Concepts in Diagnosis and Enema Reduction

Intussusception in Children: Current Concepts in Diagnosis and Enema Reduction

Intussusception in pregnancy. Case report and review of the literature

Ileocolic Intussusception in Large Cell Lymphoma of the Terminal Ileum

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