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    Go to the top of the page   ID: 20020118111724 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Ileocolic invagination
    L Hinz, H Teichler. Ileocolic invagination. PedRad [serial online] vol 2, no. 1.
    URL: www.PedRad.info/?search=20020118111724


     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    L. Hinz, H. Teichler (Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    N/A  

     
     Pediatric Radiology CasesGender:

    N/A  

     
     Pediatric Radiology CasesRegion-Organ:

    GI-Large intestine  

     
     Pediatric Radiology CasesMost likely etiology:

    physical  

     
     Pediatric Radiology CasesHistory:

    typically acute, colicy pains, sudden screaming of otherwise unnoticeable infants, eventually palpatory resistance in the right lower abdominal quadrant, often afterwards a unsymptomatic interval, vomiting, later bloody-mucousy stools.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Intussception of a section of the small intestine into a distal part thereof.
    In the case of an iliocolic invagination (intussception), the transition between Ileum and Colon ( = ileocolic invagination) is affected.
    This results in a problem of vascularization in the region of the intussception, which leads to edema and to a peristaltic interference.
    This can result in a complete ileus, which may lead to a complete intestinal wall necrosis.
    90% of intussceptions are seen as an idiopathic.
    Frequently intestinal infections play a role.
    The starting point of an intussception can both be an enlarged lymph node the course of a lymphadenitis, enlarged Peyer Plaques, little polyps, Lymphomas or a Meckel divertikulum. Also an inflamed appendix or, for example, askarides can be seen as a cause.  

     
     Pediatric Radiology CasesRadiological findings:


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Proof of a typical corcade structure (target-ring form), mostly in the right lower/midgut area. In this case, representation of of a short segment in the right midgut, distal to the ileocecal pole. The outer ring is a representation of the edematously changed colon, within it the invagination from the terminal ileum with mesenterium and a small lymph node. Proof of minimal free fluid intraabdominally.




    X-Ray 1 <- view X-Ray 1

    X-ray 1: Colon contrast enema: Contrast media is abruptly stopped with a surrounding marking of the head of the invagination up until the hepatic flexure.



    X-Ray 2 <- view X-Ray 2

    X-ray 2: Contrast media is abruptly stopped, showing also the head of the invagination.



    X-Ray 3 <- view X-Ray 3

    X-ray 3: Devagination results.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Imaging including endoscopy  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    N/A  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    A large number of the intussceptions are usually associated with an infection of the GI tract, or also an episode of uncertain abdominal complaints. Many times, intussception occurs.

    If an intussception is found in a sonographic examination, which often does not correct itself, the indication for a hydrostatic devagination (also a pneumatic devagination through air) is given.
    When a late diagnosis occurs (a period of no symptoms!) with development of ileus symptoms and the possibility of a perforation, an emergency surgical repair is indicated.

    In the later course of this illness, one may find symptoms of shock; the children are apathetic, what can often be misdiagnosed as an improvement of the situation.  

     
     Pediatric Radiology CasesComments of the author about the case:

    This case deals with a 9 month old girl. About 2 hours before the patient came to us, she suddenly started to have colicky stomach aches with violent screaming. The child was found in an obvious reduced general condition, was previously healthy, well-nourished and developed normally.

    After the sonographically working diagnosis of an intussception had been confirmed, the colonic contrast enema with hydrostatic devagination was performed. Subsequently complete recovery, further course of illness was without complication.  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Rohrschneider W
    Invagination
    Radiologe 1997 Jun;37(6) 446-53

    2. Medline: Medline
    Staatz G; Alzen G; Heimann G
    Intestinal infection, the most frequent cause of invagination in childhood: results of a 10-year clinical study
    Klin Padiatr 1998 Mar-Apr;210(2) 61-4

    3. Medline: Medline
    Hoffmann V
    Ultraschalldiagnostik in Pädiatrie und Kinderchirurgie.
    Thieme, Stuttgart New York (1996) 302-305  

     
     Pediatric Radiology CasesKeywords:

    Ileocolic, invagination, intussusception, ileocolic intussusception, ileocolic invagination, cocarde, bull's eye, target sign, devagination, colon enema, intussuscipiens, intussusceptum, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    L Hinz, H Teichler. Ileocolic invagination. PedRad [serial online] vol 2, no. 1.
    URL: www.PedRad.info/?search=20020118111724  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: GI-Large intestine
    or in the region: GI
    or in the tissue/organ: Large intestine
    or with the etiology: physical
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     
    Ileocolic invagination
    L Hinz, H Teichler. Ileocolic invagination. PedRad [serial online] vol 2, no. 1.
    URL: www.PedRad.info/?search=20020118111724


     

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    Ileocolic invagination
    Other cases by these authors:

    Search L. Hinz in Medline L. Hinz (5)   
    Search H. Teichler in Medline H. Teichler (4)   

    Ileocolic invagination  
     
    Ileocolic invagination
    L Hinz, H Teichler. Ileocolic invagination. PedRad [serial online] vol 2, no. 1.
    URL: www.PedRad.info/?search=20020118111724


     
     
    Ileocolic invagination
    L Hinz, H Teichler. Ileocolic invagination. PedRad [serial online] vol 2, no. 1.
    URL: www.PedRad.info/?search=20020118111724


     

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    Ileocolic invagination
    L Hinz, H Teichler. Ileocolic invagination. PedRad [serial online] vol 2, no. 1.
    URL: www.PedRad.info/?search=20020118111724


     




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