Test yourself
Intussusception: target, then sandwich
5 questions. Pick an answer to see whether you are right and why. Your score appears at the end.
Question 1What does the target sign represent?
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Answer b. In transverse, the rings of the outer bowel wall and the inner, telescoped bowel alternate bright and dark, like a target. In long axis the same layers make the sandwich or pseudokidney sign. Confirm in both planes.
Question 2Where do most ileocolic intussusceptions lie?
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Answer b. The ileum telescopes into the caecum and colon, so the mass usually sits along the ascending or proximal transverse colon, often in the right upper quadrant. Follow the colon around the abdomen to find it.
Question 3A small target lesion in the centre of the abdomen, without a lead point, disappears on repeat scanning. What is it most likely to be?
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Answer d. Transient small-bowel intussusceptions are smaller and shorter than ileocolic ones, lie centrally or on the left, and often reduce on their own. Interpret them with the clinical picture.
Question 4What is a lead point?
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Answer b. A lead point is a lesion which the bowel pulls along as it telescopes. Lead points are more likely outside the typical age range and in recurrent intussusception.
Question 5The bedside scan is negative in a 14-month-old with a convincing story of intermittent screaming and drawing up the legs. What do you do?
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Answer c. Point-of-care ultrasound is accurate in trained hands, but a negative scan in a high-risk story does not close the case. Missed intussusception risks ischaemia and perforation.
Practise it with us
Four or five delegates per instructor, FAMUS-accredited faculty and long, supervised time on the probe.
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