Intussusception

Set up

  • Probe: Linear
  • Mode: Peds Abdomen
  • Starting Depth: 5 cm

Views

  •  No intussusception visualized – Clip of each sweep (ascending, transverse, and descending colon)
  • Intussception visualized
    • Short axis with measurement
    • Long axis

Scanning

  • Place the patient in supine position
  • Start with the probe marker to the patient’s right in the RLQ and scan along colon as indicated in the figure below keeping probe perpendicular to the colon
  • Use graded compression to move gas out of view to visualize the bowel
  • Search for a non-compressible tissue structure along this path

Abnormal Measurements

  •  > 2.5 cm

RLQ landmarks

 

RUQ landmarks

Normal bowel

Colon and small bowel

Transverse view “target sign”

Long axis view “sandwich sign”

  

Ileo-Ilial Intussusception

< 2cm, usually with peristalsis

Intussusception mistaken for a lymph node or kidney​.

  Fix → Intussusception can be distinguished from lymph node by size and presence of concentric circles (loops of bowel).​Identify the kidneys separately to distinguish from intussusception.

Small bowel intussusception can look similar to ileocolic intussusception

  Fix → Measure abnormal structure, if less than 2cm, is small bowel intussusception and does not get referred for enema reduction.