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Sonography of Pediatric Small-Bowel Intussusception: Differentiating Surgical from Nonsurgical Cases

Martha M. Munden1, John F. Bruzzi2, Brian D. Coley3 and Reginald F. Munden2

1 Edward B. Singleton Diagnostic Imaging Services, Texas Children's Hospital, Baylor College of Medicine, Houston, TX 77030-2399.
2 Department of Diagnostic Imaging, University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 57, Houston, TX 77030.
3 Department of Radiology, Columbus Children's Hospital, Columbus, OH 43205.


Figure 1
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  		Fig. 1 —14-year-old girl with intermittent abdominal pain of several months' duration. Longitudinal sonogram shows small-bowel intussusception (arrows) measuring 14 cm in longest dimension. At surgery, lead point was found to be polyp. Diagnosis was Peutz-Jeghers syndrome. I = intussusceptum.

 

Figure 2
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  		Fig. 2 —13-month-old girl with 5-day history of vomiting and diarrhea. Transverse sonogram of left lower quadrant shows dilated, fluid-filled loops of small bowel (black arrows) and ascites (white arrow). At surgery, Meckel's diverticulum was found to be lead point.

 

Figure 3
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  		Fig. 3 —18-year-old girl with midepigastric pain for 4 months who presented with acute severe abdominal pain. Transverse midline sonogram shows small-bowel intussusception (arrows). Maximum longitudinal measurement was 14 cm. At surgery, 140 cm of necrotic small bowel was removed. There was no identifiable lead point.

 

Figure 4
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  		Fig. 4 —18-month-old girl undergoing evaluation for patent urachus. Transverse sonogram shows incidentally found small-bowel intussusception (arrows) that resolved spontaneously by end of examination. Maximum longitudinal measurement was 1.4 cm.

 

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