Case of the week 1.22.18
Publication Date: 2018-01-19
4 images
Findings
Orthogonal radiographs of the abdomen are available for interpretation.
There is mild to moderate decrease serosal detail within the peritoneal cavity some of which is due to crowding by the gastrointestinal tract.
The small intestines are diffusely markedly distended and contain mostly soft tissue opacity with multiple small fragmented gas bubbles. The descending colon is empty.
The stomach is moderately distended with soft tissue opacity and contains a large gas cap. Additionally, within the lumen of the stomach, there are multiple small pinpoint mineral opacities near the antrum and pylorus.
The margins of the liver, kidneys and spleen are somewhat obscured by the crowding and decreased detail but appear normal. The urinary bladder cannot be seen. The included musculoskeletal structures are normal for a patient this age.
Diagnosis
Changes to the gastrointestinal tract are consistent with mechanical obstruction.
Given the clinical history and the radiographic findings, intussusception the primary differential.
Surgical explore is indicated, if needed for further evaluation ultrasound could be useful .
Discussion
Ultrasound was subsequently performed and confirmed the suspicion of intussusception. The patient underwent surgery and recovered fully.
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