Presentation
Constipation for six days and repeated vomiting for three days.
Patient Data
CT images, first in the portal venous phase, and second with PO contrast.
There is so-called "bowel-within-bowel" configuration in the distal jejunum / proximal ileum in the portal venous phase scan without oral contrast. The layers of the bowel are duplicated forming concentric rings seen in the left iliac region (jejunal loops), with no proximal dilatation of the small bowel loops, no pneumatosis, associated with small volume intraperitoneal free fluid. No concomitant bowel wall masses.
The intussusception resolved on the oral contrast portion of the exam, showing its transient nature.
The red circle surrounds the transient intussusception.
Case Discussion
Intussusception occurs when one segment of bowel is pulled into a distal segment of bowell by peristalsis (bowel telescoping into itself). It can be caused by a lead point in the bowel (polyp, mass, etc.), but in the jejunum it is often a transient normal finding.
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