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    Go to the top of the page   ID: 20030829214402 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Ileocolic invagination, pneumatic devagination
    Dirk Schaper, V Hofmann. Ileocolic invagination, pneumatic devagination. PedRad [serial online] vol 3, no. 8.
    URL: www.PedRad.info/?search=20030829214402


    ( There are questions in the CMK-Mode for this topic )

     
     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:

    Dirk Schaper, V. Hofmann (Kinderchirurgie St. Barbara-KH Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    3 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    GI-Small intestine  

     
     Pediatric Radiology CasesMost likely etiology:

    unknown  

     
     Pediatric Radiology CasesHistory:

    3 year-old boy with acute, colic abdominal pains, acute vomiting, normal bowel movements, periodic intervals of relief, no fever.
    Abdomen soft, slight pain on palpation in the right lower quadrant, palpatory resistance in the right lower quadrant, bowel sounds normal.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Often this has an inflammatory cause with lymph node swelling as a root of the invagination.  

     
     Pediatric Radiology CasesRadiological findings:


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Bulls-Eye sign int he right lower quadrant.



    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Bulls-Eye sign with vasculature.



    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Airless abdomen in the upper and middle abdomen.





    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Increasing aeration by insufflation rectally. Representation of the intestinal pathology.




    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Air-filled colon with a short stop at the Bauhin's Valve (ileocecal valve).




    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Success, Insufflation of the small intestines.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Large lymph node at the ileocecal transition.



    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Obvious increase in blood supply in cecum.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Imaging including endoscopy  

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

    Small bowel invagination, colitis, Crohn's disease  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Proof of an ileocolic intussception, immediate pneumatic devagination (X-rays 1-4), after 6h re-intussception, therefore repeated pneumatic devagination. No following reoccurrence. In the sonographic follow-up examination, multiple enlarged lymph nodes can be found (ultrasound 3), the caecum shows a clear increase in vascularization (ultrasound 4). To what extent this condition is contingent upon an inflammatory response or due to the intussception can not be stated with certainty. In other cases, such an increase in circulation is rarely seen, so that one must assume that this is an inflammatory process. Supporting this theory is that the increase of circulation was seen days after the devagination as well.  

     
     Pediatric Radiology CasesComments of the author about the case:

    Note from the editor:
    The pneumatic devagination is one of the possibilities to correct an intussception. Since the devagination with air is performed using x-ray, devaginations with better contrast media (namely water-soluble contrast media) is not expected, especially since the contrast media can travel to the small intestines.

    Comments and questions to the advantages of one or the other methods are welcomed.

    The devagination pressure should be 100 cm H2O, and should not go over this value. Everyone who has performed a devagination knows that this pressure is usually not sufficient to correct a devagination.  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Hofmann V, Bartsch H.
    Changes in the diagnosis and therapy of invagination
    Zentralbl Chir. 1990;115(19):1249-58

    2. Medline: Medline
    Margarit Mallol J, Ribo Cruz JM, Martin Hortiguela ME, Barber Perez J, Claret Corominas
    Acute intestinal invagination: hydrostatic reduction vs. pneumatic reduction
    An Esp Pediatr. 1993 Jan;38(1):17-9.

    3. Medline: Medline
    Dong AT, Mong HT, Van BN.
    Acute intestinal invagination: pneumatic reduction (experience with 2033 cases)
    Arch Pediatr. 1999;6 Suppl 2:317s-319s  

     
     Pediatric Radiology CasesKeywords:

    Invagination, Intussusception, ileocolic, Intussusceptum, Devagination, small bowel intussusception, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Dirk Schaper, V Hofmann. Ileocolic invagination, pneumatic devagination. PedRad [serial online] vol 3, no. 8.
    URL: www.PedRad.info/?search=20030829214402  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: GI-Small intestine
    or in the region: GI
    or in the tissue/organ: Small intestine
    or with the etiology: unknown
     
     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, pneumatic devagination
    Dirk Schaper, V Hofmann. Ileocolic invagination, pneumatic devagination. PedRad [serial online] vol 3, no. 8.
    URL: www.PedRad.info/?search=20030829214402


    ( There are questions in the CMK-Mode for this topic )

     

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    Ileocolic invagination, pneumatic devagination
    Other cases by these authors:

    Search Dirk Schaper in Medline Dirk Schaper (43)   
    Search V. Hofmann in Medline V. Hofmann (17)   

    Ileocolic invagination, pneumatic devagination  
     
    Ileocolic invagination, pneumatic devagination
    Dirk Schaper, V Hofmann. Ileocolic invagination, pneumatic devagination. PedRad [serial online] vol 3, no. 8.
    URL: www.PedRad.info/?search=20030829214402


    ( There are questions in the CMK-Mode for this topic )

     

    Which diagnosis have other collegues guessed?


    • Enteric Intussusception
      Votes: 2 (8 %)


    • Colitis
      Votes: 2 (8 %)


    • Crohn's disease
      Votes: 1 (4 %)


    • Iliocolic invagination
      Votes: 16 (69 %)


    • Ileus
      Votes: 2 (8 %)



        Total answers: 23

     
    Ileocolic invagination, pneumatic devagination
    Dirk Schaper, V Hofmann. Ileocolic invagination, pneumatic devagination. PedRad [serial online] vol 3, no. 8.
    URL: www.PedRad.info/?search=20030829214402


    ( There are questions in the CMK-Mode for this topic )

     

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    Ileocolic invagination, pneumatic devagination
    Dirk Schaper, V Hofmann. Ileocolic invagination, pneumatic devagination. PedRad [serial online] vol 3, no. 8.
    URL: www.PedRad.info/?search=20030829214402


    ( There are questions in the CMK-Mode for this topic )

     




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