Duodenal obstruction caused by ileocolic intussusception in the absence of intestinal malrotation is extremely rare. We present and discuss the imaging findings in an infant with an intussusception secondary to a duplication cyst in whom sonography also showed inversion of the orientation of the mesenteric vessels and a distended stomach. A contrast medium study revealed a proximal duodenal obstruction with a beak appearance suggestive of midgut volvulus. At surgery, an ileocolic intussusception causing duodenal obstruction without concomitant malrotation or volvulus was found. The combination of duodenal obstruction and abnormal relationship of the mesenteric vessels as a result of ileocolic intussusception has not previously been reported in the literature.
Intussusception Malrotation Duodenal obstruction
This is a preview of subscription content, log in to check access.
Strouse PJ, DiPietro MA, Mogbo KI (1995) Ileocolic intussusception presenting with bilious vomiting due to extrinsic duodenal obstruction. Pediatr Radiol 25:S167–S168PubMedGoogle Scholar
Golladay ES, Seibert JJ (1980) Ileo-colic intussusception masquerading as midgut volvulus. J Ark Med Soc 77:195–196PubMedGoogle Scholar
Brereton RJ, Taylor B, Hall CM (1986) Intussusception and intestinal malrotation in infants: Waugh’s syndrome. Br J Surg 73:55–57PubMedGoogle Scholar
Burke TE, Fitzgerald RJ (1985) Intussusception, volvulus and malrotation. Aust N Z J Surg 55:73–74PubMedGoogle Scholar
Jain SK (1989) Intestinal malrotation and midgut volvulus with intussusception: an unusual association. Arch Surg 124:509PubMedGoogle Scholar
Dufour D, Delaet MH, Dassonville M, et al (1992) Midgut malrotation, the reliability of sonographic diagnosis. Pediatr Radiol 22:21–23PubMedGoogle Scholar
Weinberger E, Winters WD, Liddell RM (1992) Sonographic diagnosis of intestinal malrotation in infants: importance of the relative positions of the superior mesenteric vein and artery. AJR Am J Roentgenol 159:825–828PubMedGoogle Scholar
Zerin JM, DiPietro MA (1991) Mesenteric vascular anatomy at CT: normal and abnormal appearances. Radiology 179:739–742PubMedGoogle Scholar
Papadopoulou F, Efremidis SC, Raptopoulou A, et al (1996) Distal ileocolic intussusception: another cause of inversion of superior mesenteric vessels in infants. AJR Am J Roentgenol 167:1243–1246PubMedGoogle Scholar