| |||||||
 | |||||||
 |
| |
 | ||
 |  | |
Quiz Prize Rules Current Rankings
DIAGNOSIS:Intussusception
On plain and contrast CT, bowel-in-bowel appearance (Fig. 4) is seen in the mid-abdomen with separate visualization of the large bowel loops. This is characteristic of jejuno-jejunal intussusception. An isodense polyp is noted at the apex of the intussusceptum, which is the leading point for the intussusception.
Intussusception is usually a disease of children 6 months to 4 years old in which the ileum (intussusceptum) invaginates into the colon (intussuscepiens)—an ileocolic intussusception. In this age group, there is usually no lead point, and the cause is thought to be a viral infection that results in either enlarged ileocolic lymph nodes or bowel-wall inflammation. Entero-enteric intussusceptions are rare in children. Intussusceptions are much less common in adults, who account for 10% of all intussusceptions, and unlike in children, a lead point is usually found. In adults, intussusceptions may be ileocolic, colocolic, enteroenteric, or jejunogastric, and there is no anatomic predilection. The lead points of adult intussusceptions that involve the colon are usually malignant (carcinoma, lymphoma), whereas those that involve the small bowel tend to be benign (lipoma, polyp, Meckel diverticulum, sprue, or from lymphoid hyperplasia secondary to viral infection). In this case a polyp is seen at the apex.
Symptoms in adults tend to be more chronic or intermittent and include pain, constipation, weight loss, or a palpable abdominal mass at physical examination.
The CT findings in intussusception are usually classical. The CT features include:
(a) A target-like or sausage-like mass, in which the inner central area represents the invaginated intussusceptum that is surrounded by its mesenteric fat and associated vasculature, all of which are surrounded by the thick-walled intussuscepiens.
(b) Oral contrast material trapped between the opposing walls of the intussusceptum and intussuscepiens.
(c) A soft-tissue mass secondary to the intussusception, possibly with the accompanying lead point, telescoping into the intussuscepiens. If blood supply is compromised, bowel-wall thickening or intramural air may be seen.
Although intussusception can be diagnosed by means of CT in nearly all cases, it is rare to be able to demonstrate the lead point preoperatively. A lipoma can be diagnosed if a smooth mass of fat attenuation (-50 to -100 HU) is identified within the lumen of the intussuscepiens. A polyp may be seen as an enhancing isodense lesion at the apex of the intussusceptum.
Ultrasonography also can depict the typical multilayered appearance consisting of alternating hyperechoic and hypoechoic concentric rings that represent alternating layers of mucosa, bowel wall, and mesenteric fat in cross section.
If the colon is involved, barium enema examination may show obstruction to retrograde flow secondary to a smooth filling defect that represents the leading edge of the intussuscepted bowel or a "coiled-spring" appearance if contrast material outlines the invaginated intussusceptum.
Disclaimer: No editorial attempt has been made to check the discussion. Any copyright violation or plagiarism by the authors, is directly and entirely the responsibility of the author(s). REF, www.refindia.net and its trustees will not be liable for any issues that arise as a result of the authors’ inability to follow ethical standards and rules
PubMed References for Intussusception
At any given time this link will provide references from Pubmed, including the most recent updates. Retrievals are designed to include articles available free and also Indian studies. For Indian articles, in case there is no link to the full article,you could check out the archives from the journal's website, through this list.
The following radiologists have answered this quiz correctly.
Names
Abhilash Jayaram
Ahamad Mastan Mukarrab
Ajay Kumar
Ajay Taranath
Ajitsinh Vadher
Amar Kumar Singh
Amardeep Bhatia
Amarnath C
Amit Jain
Amit Suri
Amol Gautam
Anand Gupta
Anand S H
Anbalagan Kannivelu
Anil Dasyam
Anita Khinvesra
Anjali Sujith
Anubhav Khandelwal
Anurag Tandon
Arunan L
Arvind Bhan
Arvind Kalra
Ashish Gupta
Ashish Jain
Ashok Kumar R
Ashutosh Prakash
Ashwani Singh Rathor
Ashwini Sankhe
Austin Thomas
B B Sharma
Babu Peter
C V Subbarao
D N Rao
Daksha Bhansali
Deepak Bhatia
Dharmashi Bhate
Dipti Khajanchi
Divyata Hingwala
Doaa Hasan
Edmund Moses
Esakkiammal P
Femina Zubair
Franzil Miranda
Ganesh Agrawal
Ganesh Rajagopal
Geetha B
Genin Giles
George Koshy
Gopinath TN
Govardhan Maheshwari
Guillermina Ochua
Hetal Patel
Hitesh Malhotra
Inder Krishan Sharma
Jai Thakur
Jaideep Thakur
Jeshil Shah
Jitendra Ashtekar
Joseph Selvakumar
Julie Arora
Jyoti Sureka
Kajal Shah
Kalpana Radhakrishnan
Kalpin G Patel
Kapil Naik
Karthik Ganesan
Karunakaran M
Kiran Parmar
Kisan Khilari
Kishor Barhate
Komal Kothari
Komal Sharma
Kumaresh Biradar
Kusuma Kurmayagari
M Ravindranath
Mahavir Swami
Mahesh Prakash
Manisha Jana
Manjot Kaur
Manphool Singhal
Mansi Awasthi
Mariam Eapen
Meghana Aklujkar
Minal Seth
Miriam Buckley
Mohit Agarwal
Mohit Gupta
Monika Sharma
Muddassir Rashid
Muneesh Sharma
Murugan K
N Eshwar Chandra
Nabil Sherif
Nakkeeran S
Natasha Kacker
Naveen Kulkarni
NBS Mani
Nehal Shah
Nitin Parikh
Nitin Singh
Omer Ata
Padma M R
Palash Jyoti Das
Paresh Dedhia
Paresh Desai
Partha Hazarika
Pooja Singh
Prathima Ranganath
Pratibha Bandgar
Praveen Kumar Patel
Preeti Gupta
Preshit Javadekar
Puneet Mittal
Punit Sharma
Pushpender Gupta
R Rajakumar
Rachita Khot
Raj Pandya
Rajal Choudhary
Rajesh Thampy
Rajeshkannan R
Rajkumar Jadhav
Rajneesh Galwa
Rakesh Bhatia
Rakhee Sanzgiri
Rakshit Kumar
Ram Prakash Galwa
Ramakrishna Meher
Ramesh K Pandey
Randall Varghese
Ranjeet Narlawar
Rashmi Katre
Ravi Bikkina
Reeta Gupta
Reshma Dalvi
Roozbeh Barikbin
Ruchika Sharma Rajan
S S Bakshi
Sajid Hashim
Samarjit Ghuman
Sameer Gupta
Sameer Raniga
Sandeep GSK
Sandeep Kumar
Sankar Mondal
Satish Shah
Saurabh Khandelwal
Saurabh Rohatgi
Seema Medhi
Senthilkumar P
Shailendra Chaudhary
Shailendra Jain
Shaleen Rana
Sharada Joshi
Sharath G G
Shefali Shardar
Shehanaz Ellika
Shilpa Sankhe
Shivram G Iyer
Sivasubramanian S
Somenath Chatterjee
Sonali Ullal
Srabani Dhar
Sreekanth D P
Srikanth T
Srimathi C
Srinivas Prasad
Sunil Akhani
Sunita Gopalan
Surendra Kumar Gupta
Suresh Thakur
Sushant Bhadane
Sushil Mansingani
Tariq Matin
Tejaswini Deshmukh
Thapar Ravi
Trupti Prabhu Dabholkar
Tushar Chandra
Uday Surana
Umamaheshwari K B
Ushanandhini K P
V Sujatha
Vandana S Agarwal
Varghese S P Joseph
Vasanthakumar V
Venkata Subbaiah
Vickrant Malhotra
Vidula Godhamgaonkar
Vijay H V
Vijayanadh Ojili
Vikas Singhal
Vikash Kumar
Vikram Nagesh Gulati
Vinod Wadhwani
Visagan S
Vishal Saraswat
Yogendra Khalasi
Yogesh Chaudhary
|
|
|
|
|
|