A longitudinal US image shows a "pseudokidney" sign of intussusception (arrows). Arrowheads point to enlarged mesenteric lymph nodes within the intussusceptum.
A transverse US image shows a "target" sign with a hypoechoic ring of the intussuscepiens surrouning the central echogenic area of intussusceptum. Arrowheads point to enlarged nodes.
Facts
- A segment of bowel (intussusceptum) prolapses into a more distal bowel segment (intussuscepiens)
- Most frequently seen in the first two years of life but can be seen up to 4 years. If older child has intussusception, looks for a lead point such as polyp, Meckel diverticulum, lymphoma, duplication cyst.
- Classic triad: colicky pain, vomiting and bloody (red currant jelly) stools (seen in less than 25% of cases)
- X-ray is positive in only 50% of cases, and is not reliable in diagnosing this condition
Ultrasound Findings
- Modality of choice to diagnose intussusception
- "Target" sign = hypoechoic ring with an echogenic center on transverse US image
- "Pseudokidney" sign = hypoechoic bowell wall extending along a hyperechoic mucosa
- Helpful in searching for a lead point. US can provide a specific diagnosis in one-third of these cases.
Reference:
1. Daldrup-Link HE, Gooding CA. Essentials of Pediatric Radiology: A Multimodality Approach, 2010.
2. Hodler J, Von Schulthess GK, Zollikofer CL. Diseases of the Abdomen and Pelvis 2010-2013: Diagnostic Imaging and Interventional Techniques, 2010.
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