Case 5

I am presented with a series of ultrasound images obtained in the abdomen – these show a structure made up of alternating hypo-echoic and hyper-echoic layers and shaped like a kidney; on the image marked as TS (transverse), it appears like a target made up of concentric rings which again alternate between being hypoechoic and hyperechoic. These images represent telescoping of one segment of bowel into the other – the hyperechoic ring in between is the mesenteric fat which is trapped between the two segments of bowel. These features are characteristic of intussusception. There are multiple enlarged lymph nodes within this structure, which act as a lead point for intussusception. I note that colour Doppler shows preserved blood flow between the bowel loops.

I would contact the referring physician urgently and inform of findings; I would also recommend performing a CT scan to localise the site of intussusception.