Presentation
Abdominal pain with elevated WBC count.
Patient Data
Ultrasound shows a donut sign at the right iliac fossa, highly suggestive of ileocecal invagination. A CT-scan is recommended for further evaluation.
CT-scan confirms extensive ileocecal intussusception extending up to the transverse colon. The is a small nodular image near the distal invaginated small bowel, which could suggest a cecal adenocarcinoma, and which would explain the intussusception in a patient this age. There is pelvic and susmesocolic free fluid, and free fluid within the invaginated bowels.
Case Discussion
The diagnosis of ileocecal intussusception secondary to a cecal adenocarcinoma was further confirmed per-operatively and histologically.