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

9. 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

10. 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

11. 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.h tm