Colonic intussusteption in adults - role of ultrasound.
|Year of publication||2014|
|MU Faculty or unit|
|Description||Learning objectives – To present cases of adult colonic intussusception diagnosed by ultrasound imaging (US), consequently confirmed by computed tomography (CT) and to correlate the imaging appearance with emergency surgery findings and histopathology diagnosis. Background – Intussusception in adults is rare, it occurs predominantly secondary to an underlying pathology. Majority of patients present with vague abdominal complaints (localized or diffuse abdominal pain, nausea, vomiting). Intussusception is not often considered clinically in the differential diagnosis. In our practice, patients usually undergo ultrasound as a first screening method. Imaging Findings or Procedure Details – Intussusception in 4 patients (in period of last two years) were diagnosed by ultrasound and confirmed on CT because of pathognomonic appearance. It appears as a sausage-shaped mass or as a target mass, composed of the outer intussuscipiens and the central intussusceptum. There is frequently an eccentric area of fat within the mass representing the mesenteric fat. Often visible is also mesenteric vasculature leading into the lesion, rarely mesenteric lymph nodes within. 100% of our intussusception cases were secondary to an underlying pathology, with 3 cases due neoplasm, 1 cases due to non-neoplastic processes. US and CT determination of the underlying aetiology is unreliable. En bloc resection using oncologic surgical principles remains the first line treatment due to the high likelihood of underlying malignancy. Conclusion- The diagnosis of colonic intussusception is nowadays most often made by the radiologist. Awareness of pathognomonic findings allows making the correct diagnosis also by ultrasound.|