MedPix Medical Image Database COW - Case of the Week Case Contributor: Chun W Chen Affiliation: National Capital Consortium

MedPix No: 5810 - History Pt Demographics: Age = 49 y.o. Gender = woman 49 y.o. woman with a history of chronic abdominal pain - rule out diverticular disease Downloaded by (-1)

MedPix No: 5810 - EXAM & LABS Not available

Ileo-colic Intussusception - Incidental phleboliths in right pelvis. Downloaded by (-1)

Ileo-colic Intussusception - Note Phleboliths in right pelvis Downloaded by (-1)

Ileo-colic Intussusception - Note Phleboliths in right pelvis Downloaded by (-1)

Ileo-colic Intussusception - Note Phleboliths in right pelvis Downloaded by (-1)

Ileo-colic Intussusception - NOTE: the*jelly roll* of mesenteric fat drawn into the telescoping small bowel of the intussusception. Downloaded by (-1)

Ileo-colic Intussusception - NOTE: the*jelly roll* of mesenteric fat drawn into the telescoping small bowel of the intussusception. Downloaded by (-1)

Ileo-colic Intussusception - NOTE: the*jelly roll* of mesenteric fat drawn into the telescoping small bowel of the intussusception. Downloaded by (-1)

Ileo-colic Intussusception - NOTE: the*jelly roll* of mesenteric fat drawn into the telescoping small bowel of the intussusception. Downloaded by (-1)

Ileo-colic Intussusception - NOTE: the*jelly roll* of mesenteric fat drawn into the telescoping small bowel of the intussusception. Downloaded by (-1)

Ileo-colic Intussusception - NOTE: the*jelly roll* of mesenteric fat drawn into the telescoping small bowel of the intussusception. Downloaded by (-1)

Ileo-colic Intussusception 3D surface rendering (reconstruction) showing a *mass like* filling-defect inside the bowel lumen. Downloaded by (-1)

Ileo-colic Intussusception gross images Downloaded by (-1)

Ileo-colic Intussusception gross images Downloaded by (-1)

FINDINGS Supine and upright plain films show a few air fluid levels along the right side and some dilated loops of small bowel.Axial CT images show a large mass in the right abdomen extending from the region of the ascending colon to the region of the transverse colon. The mass has low attenuation centrally and areas of higher attenuation surrounding it consistent with fat filled mesentery and surrounded by edematous bowel wall. The mass does not have a typical target appearance since most of the mass was imaged in the long axis and not axial plane.There are vessels (mesenteric) invaginating into the mass. There is a lower attenuation *leading point* mass - probably mesenteric fat.

- - Meckel's diverticulum

Diagnosis: Intussusception, Carcinoma of Cecum Dx Confirmed by: Surgery

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