Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Due to an invagination of part of the intestine (intussusceptum) into the distal intestine (intussuscipiens). The intussusceptum includes mesentery as well as bowel wall and compression of the mesentery leads to a compromise of venous drainage which over time can lead to arterial perfusion being reduced which can lead to subsequent infarction and necrosis. Seventy-five percent are ileocolic, 15% are ileo-ileocolic, 10% are ileoileal or colocolic. Ninety percent are idiopathic without a distinct pathological lead point, with the probable lead point being Peyer's Patches that are hypertrophied due to antecedent viral infection. The incidence of pathological lead points increases with age. In cases with distinct pathological lead points the most common is a Meckel diverticulum followed by polyps, hematoma, or lymphoma.
The abdominal film can be normal, or it can show a rounded soft tissue mass usually in the right side of the abdomen that can cause the inferior margin of the liver to be lost. The barium or air enema will show the mass as a lobulated intraluminal filling defect that often has a coiled spring appearance.
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