3Ī paucity of bowel gas and stool within the region of the cecum could also raise concern for an intussusception but does not exclude diagnosis because a stool-filled sigmoid colon may be located within the right lower quadrant and be mistaken for the cecum. The crescent sign, a curvilinear area of air surrounding the soft tissue mass, may also be seen (Figure 1). 3 Surrounding regions of fat density corresponding to mesentery within the intussuscipiens may be identified. The most specific finding on radiography is a round, soft-tissue mass within the upper abdomen that can be seen in up to 60% of X-rays (Figure 1). 2 There are findings that raise the concern for intussusception and would warrant further imaging. Two-view radiographs, including a supine view with a lateral decubitus or upright view, demonstrate a sensitivity of 62%. Radiography is neither diagnostic nor sensitive for intussusception detection, with a wide range of documented sensitivities that correspond to the number of views obtained. Imaging Modalities Used To Diagnose Intussusception Radiography Key points regarding the lead points and ultrasound features of possible non-reducibility are highlighted, as they can be potential challenges to reducing an intussusception. In this article, we review the typical findings of intussusception in various imaging modalities used to diagnose ileocolic and small bowel intussusceptions and briefly discuss intussusception reduction. Symptomatic cases of small bowel intussusception can occur in a subset of children with predisposing underlying conditions. As small bowel-small bowel intussusceptions are incidental findings, children are usually asymptomatic. Most of these occur in the left upper quadrant in the jejunum and less often require additional workup or intervention. Small bowel-small bowel intussusceptions are frequent incidental findings as more cross-sectional imaging is performed in children. 1 Delay in diagnosis increases morbidity, including bowel ischemia and perforation, as well as mortality. Patients can present with lethargy, vomiting or decreased appetite, with fewer than 50% of patients presenting with the classic triad of red-currant jelly stool, colicky abdominal pain, and palpable abdominal mass. An ileocolic intussusception is the most common type of intussusception in children and requires urgent treatment. Both Ileocolic and small bowel-small bowel intussusceptions can occur in children. The receiving loop of bowel is called the intussuscipiens and the inner bowel is called the intussusceptum. There are two subtypes of intussusception, ileocolic and small bowel-small bowel. An intussusception is a loop of bowel telescoping into an adjacent loop of bowel. One of the top diagnostic considerations is intussusception, particularly in patients between 3 months and 3 years of age. Abdominal pain is a frequent complaint in the pediatric emergency department.
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