Intestinal intussusception described by ultrasound.

Written by Hu Qi Feng
Pediatrics
Updated on September 13, 2024
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The appearance of intussusception under ultrasound shows concentric or target ring-shaped mass images on a transverse section scan, and a sleeve sign on a longitudinal section scan. For an ultrasound-guided hydrostatic reduction, a balloon is inserted through the anus and inflated, connecting a T-tube to a Foley catheter with a side tube connected to a sphygmomanometer to monitor water pressure. Isotonic saline at a temperature of thirty to forty degrees is injected, and the target ring-shaped mass image can be seen retracting to the ileocecal region. The disappearance of the concentric circles or sleeve sign under ultrasound indicates the completion of this therapeutic diagnosis.

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Written by Hu Qi Feng
Pediatrics
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How to treat intussusception in children?

Intussusception is a life-threatening emergency that requires urgent reduction once diagnosed. Reduction methods include non-surgical and surgical therapies. Within forty-eight hours of intussusception, if the overall condition is good, there is no abdominal distension, and no significant dehydration or electrolyte imbalance, reduction can be attempted under ultrasound guidance using hydrostatic enema, air enema, or barium enema. If the intussusception has lasted beyond forty-eight to seventy-two hours, or if there is severe abdominal distention, intestinal necrosis, or perforation, surgical treatment is necessary.

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Written by Hu Qi Feng
Pediatrics
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Caused by infantile intussusception

Intussusception is divided into primary and secondary types, with 95% being primary cases, most commonly seen in infants and young children. This is due to the fact that the mesentery of the ileocecal part in infants and young children is not yet fully fixed and has a greater degree of mobility, which are structural factors that facilitate the occurrence of intussusception. The remaining 5% are secondary cases generally occurring in older children, where the affected intestines often have a clear organic cause, such as a Meckel's diverticulum turning into the ileal lumen, serving as the starting point for intussusception. Other causes like intestinal polyps, tumors, duplications, or abdominal purpura can cause the intestinal wall to swell and thicken, which can also trigger intussusception.

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Written by Hu Qi Feng
Pediatrics
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Causes of intussusception in children

The etiology of intussusception is divided into primary and secondary types, with 95% being primary, which is common in infants and young children. In infants, the mesentery of the ileocecal region is not yet fully fixed and has a larger degree of mobility, which is a structural factor conducive to the occurrence of intussusception. Secondary cases account for about 5%, often secondary to Meckel's diverticulum, intestinal polyps, intestinal tumors, intestinal duplications, and abdominal purpura causing swelling and thickening of the intestinal wall, which can lead to intussusception. Certain factors may cause a change in the rhythmic movement of the intestines leading to disorder, thereby inducing intussusception, such as changes in diet, viral infections, and diarrhea.

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Can intussusception resolve itself automatically?

Some children with intussusception may resolve spontaneously, but it is important to closely monitor their condition with ultrasound to understand the status of the intussusception. If it does not resolve on its own in a short period, immediate surgical treatment is necessary. If the ultrasound shows successful resolution, or if the child's clinical symptoms such as vomiting and abdominal pain improve and the ultrasound does not reveal any obvious abnormalities, it is considered an automatic recovery.

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Written by Hu Qi Feng
Pediatrics
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Pediatric intussusception should see which department?

Intussusception often occurs in infants and young children, so the main symptoms are vomiting, bloody stools, and abdominal pain. Therefore, the initial consultation is usually in pediatric emergency. When intussusception is suspected as a cause of acute abdomen, the doctor will conduct intestinal tube and abdominal ultrasound examinations. If the ultrasound confirms intussusception, a transfer to pediatric surgery or emergency surgery may be considered for appropriate surgical treatment. Thus, the initial choice for consultation is usually pediatrics, but after a diagnosis is confirmed, treatment should be transferred to pediatric surgery.