Small Bowel Intussusception

pediatricultrasound ♦ May 8, 2019

When is an intussusception not an intussusception?  When its a small bowel intussusception.

Small bowel intussusceptions like their counterparts the large bowel intussusceptions are the prolapsing of one part of the bowel into the immediately adjacent part of bowel. Unlike the large bowel intussusception, small bowel intussusception generally don’t require intervention, are self limiting and will usually resolve by themselves. They are much more common than large bowel intussusceptions and often occur as the result of the latest gastro bug. They present with similar symptoms to large bowel intussusceptions with acute tummy pains in young children though generally not with the drawing of knees to chest or bloody stools associated with the large bowel intussusception. They have the same ultrasound target appearances but are much smaller in size. Differentiation from large bowel intussusceptions can be made via location and size. The transverse diameter of large bowel intussusceptions will be greater than 3cm while the transverse diameter of small bowel intussusceptions will be less than 2cm. Having established by location and size that you have identified a small bowel intussusception rotate long axis on the intussusception and measure how much bowel has prolapsed (length of intussuscepted mass), if less than 3cm long it is considered not clinically relevant and will usually resolve without medical intervention with 30mins

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