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Ileotyphlitis and/or ileocecal intussusception





Tags: Gastrointestinal sonography, Images, Video, Clinical report, Esaote MyLab 70, Pediatric

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  Ileotyphlitis and/or ileocecal intussusception
#1

    Child 2 years old with suspected appendicitis or intussusception.

    At US in the lower right quadrant of the abdomen visualized version of the target sign at CFM with bloodstream (dif.diagnosis: ileocecal intussusception, ileotyphlitis, etc.).

    In most parts of the abdomen expanded bowel loops with heteroechoic content.

    The essence of this version of the target sign, atypical target: central target element - spastic colon invaginated into the wall of the expanded intestine with fluid, in longitudinal section there is a mushroom sign.

    Two straightening attempts have been made through an enema, at ultrasonography without essential dynamics.

    After the first enema at the base of "mushroom" appeared bowel segment with a thickened wall to 9mm.

    PS. Difficulties in differentiating ileotyphlitis and ileocecal intussusception include the fact that, in my experience, intussusceptions lead to a thickening of the wall of the intestinal segment that was in the intussusception by the type of hematoma, so after straightening the intussusception, the echo-pattern of the intestinal area that was in the intussusception may correspond to that in enterocolitis, moreover, these processes can be present simultaneously.

    "The main complications of ileal TB are: Massive hematochezia (that can be controlled by endoscopic coagulation therapy), bowel obstruction (14%-32% of the cases), necrosis and intestinal perforation (1%-15%), enterocutaneous fistula (2%), ileoileal fistula, mesenteric lymphadenitis with intussusception, ileal loops or intestinal volvulus (2%), ascites, purulent or stercoral peritonitis (1%-10%), septicemia, psoas abscess, liver abscess, portal hypertension in children, etc."

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