Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgment
- Section 1 Head and neck
- Section 2 Thoracic imaging
- Section 3 Cardiac imaging
- Section 4 Vascular and interventional
- Case 33 Lower extremity ischemia due to homocystinuria
- Case 34 Iatrogenic pathology masquerading as an artifact
- Case 35 Fibromuscular dysplasia
- Case 36 Traumatic vertebral arteriovenous fistulae
- Case 37 Colonic perforation during intussusception reduction
- Case 38 Juvenile nasopharyngeal angioma
- Case 39 Small bowel fistula complicating perforated appendicitis: successful treatment with tissue adhesive
- Case 40 Extrahepatic collateral arterial supply to hepatocellular carcinoma
- Case 41 Use of a curved needle to access an otherwise inaccessible abscess
- Case 42 Umbilical venous catheter malposition
- Case 43 Middle aortic syndrome
- Section 5 Gastrointestinal imaging
- Section 6 Urinary imaging
- Section 7 Endocrine - reproductive imaging
- Section 8 Fetal imaging
- Section 9 Musculoskeletal imaging
- Index
- References
Case 37 - Colonic perforation during intussusception reduction
from Section 4 - Vascular and interventional
Published online by Cambridge University Press: 05 June 2014
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgment
- Section 1 Head and neck
- Section 2 Thoracic imaging
- Section 3 Cardiac imaging
- Section 4 Vascular and interventional
- Case 33 Lower extremity ischemia due to homocystinuria
- Case 34 Iatrogenic pathology masquerading as an artifact
- Case 35 Fibromuscular dysplasia
- Case 36 Traumatic vertebral arteriovenous fistulae
- Case 37 Colonic perforation during intussusception reduction
- Case 38 Juvenile nasopharyngeal angioma
- Case 39 Small bowel fistula complicating perforated appendicitis: successful treatment with tissue adhesive
- Case 40 Extrahepatic collateral arterial supply to hepatocellular carcinoma
- Case 41 Use of a curved needle to access an otherwise inaccessible abscess
- Case 42 Umbilical venous catheter malposition
- Case 43 Middle aortic syndrome
- Section 5 Gastrointestinal imaging
- Section 6 Urinary imaging
- Section 7 Endocrine - reproductive imaging
- Section 8 Fetal imaging
- Section 9 Musculoskeletal imaging
- Index
- References
Summary
Imaging description
Figure 37.1 depicts abdominal radiographs obtained in a 14-week-old boy with vomiting and abdominal pain. Figure 37.2 depicts one image from an ultrasound study, which confirmed the diagnosis of intussusception. The patient proceeded immediately to the fluoroscopically guided pneumatic enema reduction shown in Figure 37.3. During the course of this procedure, the diagnosis was confirmed, but just as it appeared that the intussusception was reduced, a popping noise was audible. Insufflation was stopped and the pressure on the sphygmomanometer released based on the appearance at fluoroscopy (Fig. 37.3). On inspection and palpation, the patient’s abdomen was massively distended and as hard as a board. A hypodermic needle was inserted into the peritoneal cavity percutaneously, and this was exchanged over a guidewire for a 6 French locking pigtail drainage catheter through which the pneumoperitoneum was aspirated (Fig. 37.4). The patient then went to the operating room where the surgeon noted that the intussusception had been reduced. There were several serosal tears in the small bowel and colon, and there was a 1 cm perforation in the sigmoid colon, which otherwise was normal. As no gross contamination of the peritoneal cavity was present and the patient appeared well, the perforation was repaired and the area irrigated. The patient did well postoperatively.
- Type
- Chapter
- Information
- Pearls and Pitfalls in Pediatric ImagingVariants and Other Difficult Diagnoses, pp. 169 - 172Publisher: Cambridge University PressPrint publication year: 2014