Presentation
Tenderness on the right upper quadrant.
Patient Data
There is a double layered hypoechoic to hyperechoic with appearance of target sign, non compressible, aperistaltic lesion seen in the right hypochondrial region.
There is hyperemia on color doppler. There is hyperechoic well defined lesion in the left liver.
There is transverse colonic wall thickening and apple core luminal narrowing at the proximal end of the hepatic flexure of the transverse colon. Bowel within bowel configuration is demonstrated.
Multiple enlarged mesenteric lymph nodes and perilesional fat stranding is seen. There is a hypodense non enhancing well defined lesion in the left liver lobe consistent with a hemangioma.
Mild aortic and iliac arteries calcific atherosclerosis.
Case Discussion
Intussusception is described as the invagination of one segment of the colon into a neighboring section of the bowel. Adult intussusception is uncommon, accounting for 1–5% of intestinal obstructions1. Secondary intussusception is caused by organic lesions such as inflammatory bowel disease, postoperative adhesions, Meckel's diverticulum, benign and malignant lesions, metastatic neoplasms, or even iatrogenically, due to the presence of intestinal tubes, jejunostomy feeding tubes, or after gastric surgery 2.
Classic findings on CT include “target,” “bulls-eye,” or sausage-shaped lesions as a concentric hyperdense double ring 1.
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