Intussusception

Intussusception is the introversion or enfolding of one segment of bowel within the lumen of a contiguous segment of bowel. This usually occurs in the ileocolic region, but may be seen in any area of the intestine. In adults, intussusception is often subacute, chronic or intermittent, and may be caused by a tumor, Meckel's diverticulum, lymphoma, duplication, mesenteric lymphadenopathy, foreign body, or cystic fibrosis. Plain films demonstrate a soft tissue mass and small bowel obstruction. CT shows a characteristic donut or target-shaped intestinal mass and is usually diagnostic. Barium studies exhibit a coiled spring appearance due to barium getting trapped between the intussusceptum and receiving bowel (intussuscepiens). Ultrasound may display a similar pattern of alternating hyperechoic and hypoechoic rings in cross-section. Patients are hospitalized, given IV fluids and a NG tube, and the intussusception may be corrected by non-surgical or surgical manipulation.

Barium studies demonstrating intussusception

Intussuseption - Air enema of patient with intussuseption.  Note the intusuccipiens (arrow).

Surgical specimen from intussusception resection

Mass in the lumen causing the intussusception in this patient