Intussusception (medical disorder): Difference between revisions

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[[File:Intussusception on ultrasound.jpg|thumb|An [[ultrasound]] shows a target sign—characteristic for intussusception]]
An intussusception is often suspected based on history and physical exam, including observation of [[Dance's sign]]. A digital [[rectal examination]] is particularly helpful in children, as part of the intussusceptum may be felt by the finger. A definite diagnosis often requires confirmation by diagnostic imaging modalities. [[Ultrasound]] is the imaging modality of choice for diagnosis and exclusion of intussusception, due to its high accuracy and lack of radiation. The appearance of target sign (also called "doughnut sign" on a sonograph, usually around 3&nbsp;cm in diameter, confirms the diagnosis. The image seen on transverse [[Medical ultrasonography|sonography]] or [[Computed tomography of the abdomen and pelvis|computed tomography]] is that of a doughnut shape, created by the [[hyperechogenicity|hyperechoic]] central core of [[Human gastrointestinal tract#Lower gastrointestinal tract|bowel]] and [[mesentery]] surrounded by the [[hypoechogenicity|hypoechoic]] outer [[edema]]tous bowel.<ref name=Park/> In longitudinal imaging, intussusception resembles a sandwich.<ref name=Park>{{cite journal |vauthors=Park NH, Park SI, Park CS, Lee EJ, Kim MS, Ryu JA, Bae JM |title=Ultrasonographic findings of small bowel intussusception, focusing on differentiation from ileocolic intussusception|journal=Br J Radiol|date =2007|volume=80|issue=958|pages=798–802 |pmid=17875595 |issn=0007-1285|doi=10.1259/bjr/61246651 |url= }}</ref> It is also called "pseudokidney" sign because hyperechoic tubular centre is covered by a hypoechoic rim producing a kidney-like appearance.<ref>{{Cite journal |last1=Charles |first1=T. |last2=Penninga |first2=L. |last3=Reurings |first3=J. C. |last4=Berry |first4=M. C. J. |date=January 2015 |title=Intussusception in Children: A Clinical Review |journal=Acta Chirurgica Belgica |language=en |volume=115 |issue=5 |pages=327–333 |doi=10.1080/00015458.2015.11681124 |pmid=26559998 |s2cid=21843245 |issn=0001-5458}}</ref>
 
An [[x-ray]] of the abdomen may be indicated to check for intestinal obstruction or free intraperitoneal gas. The latter finding implies that bowel perforation has already occurred. Some institutions use [[air enema]] for diagnosis, as the same procedure can be used for treatment.<ref>{{cite journal |author=C Surendranath Singh |author2=M.l. Prakash |url=http://www.webmedcentral.com/article_view/2052 |title=Adult Intussception : A Case Report |journal=Webmedcentral |publisher=Webmed Central |doi=10.9754/journal.wmc.2011.002052 |issn=2046-1690 |date=28 Jul 2011 |access-date=June 5, 2016 |url-status=live |archiveurl=https://web.archive.org/web/20160610194158/http://www.webmedcentral.com/article_view/2052 |archivedate=June 10, 2016 }}</ref>{{Citation needed |reason=this source does not talk about enemas |date=June 2016}}
 
=== Classification===