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Age: 1

Sex: Female

Indication: Vomiting

Save ("V")

Case #11


Findings

  • Rounded soft tissue density in the right hemiabdomen seen on both views
  • Nonobstructive bowel gas pattern
  • No evidence of free intraperitoneal air
  • No abnormal intraabdominal mass effect or calcification
  • No acute findings in the chest


Diagnosis

  • Intussusception

Sample Report

Rounded soft tissue density in the right hemiabdomen seen on both views, which raises concern for intussusception. Recommend ultrasound for further evaluation.

Nonobstructive bowel gas pattern.

No evidence of free intraperitoneal air.

No abnormal intraabdominal mass effect or calcification.

No acute findings in the chest.


Discussion

  • Radiographic signs of intussusception include:
    • Soft tissue mass in the right hemiabdomen, which can have a targetoid appearance
    • Distal small bowel obstruction
    • Crescent of gas outlining the intussusceptum in the proximal colon
  • While many of the radiographic findings of intussusception are nonspecific, it is important to alert the clinician to the possibility of intussusception when there is evidence of distal small bowel obstruction and/or a mass-like soft tissue density in the right hemiabdomen


Images

Red arrows: rounded soft tissue density in the right hemiabdomen. Red arrows: targetoid-appearing ileocolic intussusception confirmed on the subsequent ultrasound.

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