E1722. Intussusception: It’s Like a Bowel Within a Bowel
A Review of the Common and Uncommon Etiologies Causing Intussusception in Children
Authors
Kevin Mason;
Cincinnati Children's Hospital and Medical Center; University of Cincinnati
Alex Towbin;
Cincinnati Children's Hospital and Medical Center; University of Cincinnati
Background
Intussusception occurs when a penetrating aspect of bowel (intussusceptum) telescopes or invaginates into a receiving lumen (intussuscipiens). Iliocolonic intussusception is an emergent condition in children that can lead to bowel obstruction and ultimately bowel necrosis. While it most commonly occurs as a result of lymphoid hyperplasia of the distal small bowel, it may be precipitated by other causes or lead points. The purpose of this exhibit is to describe the common and uncommon causes or lead points that may cause pediatric intussusception.
Educational Goals / Teaching Points
This exhibit will review and assess common and uncommon etiologies of intussusception including but not limited to: Burkitt lymphoma, fibrovascular polyps, appendicitis, Henoch-Schönlein purpura, and recent retroperitoneal surgery. Unique imaging findings of each entity will be highlighted. These differences will then be used to help guide recommendations for therapy.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit will highlight the work-up of suspected intussusception and will focus on the key clinical and imaging findings that allow the radiologist to differentiate idiopathic causes of intussusception from those caused by a pathologic lead point. After a diagnosis has been made, the radiologist will be guided through the appropriate treatment options including enema reduction.
Conclusion
Intussusception is a leading cause of pediatric abdominal pain. Understanding the imaging findings of the typical and atypical causes of intussusception will help the radiologist to guide therapy and provide timely care for their patient.
