A 6yo boy is in the ED with his third episode of intussusception over the past year. Previous episodes presented with colicky abdominal pain and stool guaiac positive, and were successfully managed using barium enemas. He has been completely well between episodes. What imaging study is indicated to assess for the most common cause of a pathologic lead point?
A. Complete ultrasound of the abdomen
B. Computed tomography of the abdomen with oral and IV contrast
C. Upper gastrointestinal study with small bowel follow-through
D. Technetium-99m-pertechnetate scintigraphy
E. Magnetic resonance imaging of the abdomen
October 6, 2016 at 12:19 am
Answer: D. Even patients with recurrent intussusceptions often do not a pathologic lead point, but when they do, the most common is a Meckel diverticulum, which is diagnosed with a Meckel scan (or fancy name, Technetium-99m0pertechnetate scintigraphy). Here’s some various PED EM morsels: http://pedemmorsels.com/intussusception/
http://pedemmorsels.com/intussusception-altered-mental-status/
http://pedemmorsels.com/meckels-diverticulum/