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CT Case: 8 year old with Abdominal Pain

CT Case: 8 year old with Abdominal Pain. Nick Hartman June 20, 2008. Clinical Story. 8 yo male s/p heart transplant as a neonate Presents today with colicky abdominal pain x 2 days, with anorexia and bilious emesis VS: T 36.3 RR 28 HR 116 BP 113/78. Abdominal exam.

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CT Case: 8 year old with Abdominal Pain

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  1. CT Case: 8 year old with Abdominal Pain Nick Hartman June 20, 2008

  2. Clinical Story • 8 yo male s/p heart transplant as a neonate • Presents today with colicky abdominal pain x 2 days, with anorexia and bilious emesis • VS: T 36.3 RR 28 HR 116 BP 113/78

  3. Abdominal exam • Grossly distended • Hyperactive bowel sounds • Next step: CT scan

  4. Diagnosis: Intussusception • Most common in children aged 6 mo-2 y • Typically presents with abdominal pain, vomiting and bloody stools • For patients above age 2, suspect anatomic abnormality: Meckel’s, tumor, etc. • Radiology: findings of SBO, plus oval “reniform” mass, and intraluminal soft tissue structures • Can often be reduced with barium enema, otherwise treat surgically

  5. Follow-Up • Surgery was performed to reduce the intussusception and to remove the soft tissue mass found to be the cause • Tissue pathology revealed lymphoproliferative disorder • Pt discharged on hospital day 5 with resolved abdominal symptoms, eating normally

  6. References • Gayer G, et al. Adult intussusception – a CT diagnosis. The British Journal of Radiology 2002; 75: 185-190. • Wood BP. Intussusception, Child. E-medicine article, updated 2005. http://www.emedicine.com/RADIO/topic366.htm

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