CT OF INTUSSUSCEPTION IN THE PEDIATRIC-PATIENT - DIAGNOSIS AND PITFALLS

Intussusception in the pediatric patient may have a varied clinical pr esentation depending on its location, presence of lead paint, intermit tent occurrence, or underlying systemic disease. Computed tomography ( CT) may be used at times in the evaluation of children with complicate d presentations. The purpose of this investigation was to review the f indings of CT images obtained in children with intussusception. Five p atients with intussusception were diagnosed by CT at our institution b etween 1989 and 1994. An intraluminal mass was found in all patients. Intraluminal eccentrically located fat, as well as the target sign of alternating layers of high and low attenuation, was seen in most patie nts. In patients with a more long-standing process, fluid-distended lo ops, inflammation, and loss of tissue planes were seen and corresponde d with necrosis and areas of nonviable bowel found at surgery. Finally , potential pitfalls with the layered or target appearance are discuss ed in the form of two patients who were initially felt to have intussu sception at CT, but in whom the target appearance was later found to b e due to other processes.