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Age: 2

Sex: Male

Indication: Abdominal pain

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Case #11


  • Telescoping of the terminal ileum into the cecum and ascending colon


Ileocolic intussusception

Sample Report

Telescoping of the terminal ileum into the cecum and ascending colon, consistent with ileocolic intussusception


  • Ileocolic intussusception is a common cause for an acute abdomen in young children and is most common between the ages of 6 months and 2 years
  • In children, a lead point is not usually identified, though non-reducibility or abnormal intussusception location (e.g. colocolonic) should prompt further search for a lead point
  • Intussusceptions in older children and adults commonly have an associated lead point, with the exception of transient short segment enteroenteric intussusceptions
  • Ultrasound is the preferred imaging modality for assessing pediatric patients with suspected intussusception
  • Look for telescoped appearance of the terminal ileum within the cecum and ascending colon
    • Imaged in cross-section, this creates a target appearance with the decompressed intussusceptum in the center surrounded by hyperechoic mesenteric fat surrounded by the intussuscipiens
    • Adding rings to the target appearance, the mucosal and muscularis bowel wall layers are typically hyperechoic whereas the submucosa is typically hypoechoic
  • Helpful terminology:
    • Intussusceptum: bowel segment that telescopes into another bowel loop (on the inside of the target)
    • Intussuscipiens: bowel segment that receives the intussusceptum (on the outside of the target)
  • First line treatment is air enema


Ileocolic intussusception imaged in cross-section creating a target appearance with the intussusceptum in the center (red outline) surrounded by mesenteric fat (yellow outline) surrounded by the intussuscipiens (blue outline).

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