July 21, 2012

Abdominal X Ray: Intussusception

6 months old baby girl with no known medical illness and post weaning one week was brought to hospital by her mother after developing diarrhea, vomiting and fever for one day. The mother describes the diarrhea as a watery stool associated with mucous and blood streak.

This is the picture of her abdominal X ray which shows small bowel dilatation (as evidence of central position and valvulae) and thickening of the bowel wall at right lower quadrant. There was no free gas and no paucity of the bowel gas. Ultrasound abdomen shows classical sign of intussusception which is a “Target Lesion” sign. A diagnosis of Subacute Intestinal Obstruction Secondary to Intussusception was made  and patient was then posted for emergency laparotomy for reduction of intussusception, KIV bowel resection and end to end anastomosis. Intra operatively, there was a ileo-colic intussusception with bluish discoloration of bowel. Otherwise the integrity of the bowel still preserve and the color return to pinkish color after warm packing. Post operatively was uneventful.

Notes: Credited to Dr Juhara Haron (Radiologist USM) for guidance in interpreting the X Ray

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