Intussusception x ray

Jump to: navigation, search

Intussusception Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Intussusception from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Intussusception On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Intussusception

All Images
X-rays
Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Intussusception

CDC on Intussusception

Intussusception in the news

Blogs on Intussusception

Directions to Hospitals Treating Intussusception

Risk calculators and risk factors for Intussusception

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sargun Singh Walia M.B.B.S.[2]

Overview

An x-ray may be helpful in the diagnosis of intussusception. Plain abdominal xray of patient is done in supine and upright position. Findings on an x-ray suggestive of/diagnostic of intussusception include absence of air in right lower quadrant and right upper quadrant, soft tissue density in right upper quadrant in 25-60% of patients, and normal in 60% of cases.

X Ray Images

Plain film

  • An x-ray may be helpful in the diagnosis of intussusception. Findings on an x-ray suggestive of/diagnostic of intussusception include:
    • Normal in 60% of cases
    • Absence of air in right lower quadrant and right upper quadrant
    • Soft tissue density in right upper quadrant in 25-60% of patients
    • Distended loops of bowel with absence of colonic gas (sign of intestinal obstruction)
    • Target sign[1]
      • Two concentric radiolucent circles superimposed on the right kidney
      • This signifies peritoneal fat around the intussusception
      • A study shows target sign is present in 26% of patients[2]
    • Crescent sign
    • Concealed liver margin[3]
    • Xrays cannot be used to exclude intussusception in patients where suspicion of intussusception is very high[4]
    • A study conducted on patients of intussusception showed negative x-ray findings in 20%[5]
    • If suspicion of intussusception is low in a patient. X-ray showing air in the cecum or terminal ileum can exclude intussusception[6]
  • An x-ray can be used in cases of low suspicion. But, ultrasound is superior in diagnosing and excluding intussusception
Soft tissue mass projects over the right lower abdomen. No bowel dilation. Source: Case courtesy of Dr Eric F Greif, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/29373">rID: 29373</a>

References

  1. Ratcliffe JF, Fong S, Cheong I, O'Connell P (1992). "Plain film diagnosis of intussusception: prevalence of the target sign". AJR Am J Roentgenol. 158 (3): 619–21. doi:10.2214/ajr.158.3.1739006. PMID 1739006.
  2. Ratcliffe JF, Fong S, Cheong I, O'Connell P (1992). "Plain film diagnosis of intussusception: prevalence of the target sign". AJR Am J Roentgenol. 158 (3): 619–21. doi:10.2214/ajr.158.3.1739006. PMID 1739006.
  3. Saverino BP, Lava C, Lowe LH, Rivard DC (2010). "Radiographic findings in the diagnosis of pediatric ileocolic intussusception: comparison to a control population". Pediatr Emerg Care. 26 (4): 281–4. PMID 20401973.
  4. Carroll AG, Kavanagh RG, Ni Leidhin C, Cullinan NM, Lavelle LP, Malone DE (2017). "Comparative Effectiveness of Imaging Modalities for the Diagnosis and Treatment of Intussusception: A Critically Appraised Topic". Acad Radiol. 24 (5): 521–529. doi:10.1016/j.acra.2017.01.002. PMID 28268146.
  5. Weihmiller SN, Buonomo C, Bachur R (2011). "Risk stratification of children being evaluated for intussusception". Pediatrics. 127 (2): e296–303. doi:10.1542/peds.2010-2432. PMID 21242220.
  6. Roskind CG, Kamdar G, Ruzal-Shapiro CB, Bennett JE, Dayan PS (2012). "Accuracy of plain radiographs to exclude the diagnosis of intussusception". Pediatr Emerg Care. 28 (9): 855–8. doi:10.1097/PEC.0b013e318267ea38. PMID 22929143.