A 5-year-old child presents with intermittent abdominal pain, rectal bleeding, and a palpable abdominal mass. Ultrasound shows a lead point-associated intussusception. What feature on ultrasound is most commonly described?
- A 'Double bubble sign'
- B 'Target sign' (or 'doughnut sign') on transverse section and 'pseudokidney sign' on longitudinal section ✓
- C 'Snowstorm appearance' of the bowel wall
- D 'Corkscrew sign' of the twisted mesentery
Correct answer: B. 'Target sign' (or 'doughnut sign') on transverse section and 'pseudokidney sign' on longitudinal section
Explanation
Intussusception has a characteristic ultrasound appearance: the 'target sign' or 'doughnut sign' on transverse section (concentric rings of hypo- and hyperechoic tissue representing the intussusceptum within the intussuscipiens) and the 'pseudokidney sign' on longitudinal section (resembling a kidney due to layered echogenicity). These are pathognomonic for intussusception. The 'double bubble sign' is seen in duodenal atresia. The 'snowstorm' pattern suggests NEC. 'Corkscrew sign' is seen on contrast enema/upper GI series in malrotation.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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