COTW August 1st: A 3-year old male with intermittent abdominal pain for 3 days...

The patient was having 5-10 minute episodes of abdominal pain recurring about every 30 minutes, and had another one in the ED… so you put a probe on it…

At the beginning of the clip, note the concentric structures separated by a thin, anechoic stripe forming a target shape. This indicates a cross-sectional view of bowel inside bowel.

By the end of the clip, the probe was rotated to obtain a longitudinal view showing the telescoping of bowel into bowel.

These findings are consistent with intestinal intussusception, which was later reduced with an enema.

Here’s another view highlighting the inner bowel:

intu 2.gif

To perform this study, use the linear probe starting on RLQ and work your way up to the RUQ. Always remember that bowel should not be present within bowel. Usually you would find it by then, but if not, you can go across to the LUQ to the LLQ to trace the entire colon.