Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Case 50 Simulated active bleeding
- Case 51 Pseudopneumoperitoneum
- Case 52 Intra-abdominal focal fat infarction: epiploic appendagitis and omental infarction
- Case 53 False-negative and False-positive FAST
- Liver and biliary
- Spleen
- Pancreas
- Bowel
- Case 61 Pseudothickening of the bowel wall
- Case 62 Small bowel transient intussusception
- Case 63 Duodenal diverticulum
- Case 64 Pseudopneumatosis
- Case 65 Pneumatosis intestinalis
- Case 66 Pseudoappendicitis
- Kidney and ureter
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Index
- References
Case 62 - Small bowel transient intussusception
from Bowel
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Section 1 Brain, head, and neck
- Section 2 Spine
- Section 3 Thorax
- Section 4 Cardiovascular
- Section 5 Abdomen
- Case 50 Simulated active bleeding
- Case 51 Pseudopneumoperitoneum
- Case 52 Intra-abdominal focal fat infarction: epiploic appendagitis and omental infarction
- Case 53 False-negative and False-positive FAST
- Liver and biliary
- Spleen
- Pancreas
- Bowel
- Case 61 Pseudothickening of the bowel wall
- Case 62 Small bowel transient intussusception
- Case 63 Duodenal diverticulum
- Case 64 Pseudopneumatosis
- Case 65 Pneumatosis intestinalis
- Case 66 Pseudoappendicitis
- Kidney and ureter
- Section 6 Pelvis
- Section 7 Musculoskeletal
- Section 8 Pediatrics
- Index
- References
Summary
Imaging description
The widespread use of CT has led to increased detection of small bowel intussusceptions (SBI) [1], which are identified in 0.5% of non-selective abdominal-pelvic CTs [2].
An intussusception occurs when a segment of bowel and its mesentery (the intussusceptum) invaginates or telescopes into a contiguous segment of bowel (the intussuscipiens) [1]. An intussusception may be identified on CT, MRI, ultrasound, or fluoroscopy.
On contrast-enhanced CT, a bowel within bowel appearance is noted. On transverse short axis images through the bowel, a classic “target” appearance results if mesenteric fat is visible between the two segments of bowel in the intussusceptum, and/or fluid is present between the intussusceptum and intussuscipiens (Figure 62.1). On a longitudinal view, similar structures may be identified in a “sausage-shaped” mass."
Similar corresponding findings are noted on ultrasound, where they may be referred to as the “doughnut sign” on a transverse image or the “sandwich sign” on a longitudinal image [3].
Importance
Small bowel intussusception accounts for 5–16% of adult intussusceptions [4]. In the past, the standard of care for intussusception in adults was surgical resection to treat symptoms and for pathologic evaluation [5], as malignancy was reported in 24% of enteric intussusceptions and 54% of colonic intussusceptions [6]. These data were generally based on surgical series in patients with obstructive symptoms and intraoperative diagnoses [2]. These studies clearly would not have included many of the transient SBI currently detected on imaging, which explains the different rates of pathology associated with SBI in more recent studies.
- Type
- Chapter
- Information
- Pearls and Pitfalls in Emergency RadiologyVariants and Other Difficult Diagnoses, pp. 203 - 204Publisher: Cambridge University PressPrint publication year: 2013