The result is bowel obstruction and inflammatory bowel changes ranging from thickening to ischemia of the intestine wall selleck chemical (21). Diagnosis Preoperative diagnosis of intussusception is very challenging and difficult due to the variability of the clinical presentation. Plain abdominal films are the first diagnostic method, since in most cases the symptoms of intestinal obstruction dominate the clinical picture. Abdominal films usually reveal signs of intestinal obstruction and usually provide information regarding the possible site of obstruction (22). Upper gastrointestinal contrast series may show a ��stacked coin�� or ��coil-spring�� appearance, while a barium enema examination may be useful in patients with colo-colic or ileo-colic intussusception, during which a ��cup-shaped�� filling defect or ��spiral�� or ��coil-spring�� appearances are sometimes characteristically demonstrated (23).

In addition, ultrasonography is widely considered a useful method for the diagnosis of intussusceptions (24). Interestingly, the imaging features of intussusception include the famous ��target�� or ��doughnut�� signs on the transverse view and the ��pseudo-kidney�� or ��hay-fork�� sign in the longitudinal view (25). Undoubtedly, this procedure requires an appropriate interpretation by an experienced radiologist, in order to establish the diagnosis of intussusception. However, obesity and the presence of massive air in the distended bowel loops can many times limit the image quality and the diagnostic accuracy of this method (26).

Computed tomography (CT) seems to be the most important and sensitive diagnostic method in making a preoperative diagnosis of adult intussusception, especially in patients presented with non-specific abdominal pain (27, 28). Interestingly, the reported diagnostic accuracy of CT is 58%�C100% (29). The characteristic imaging features of CT include an unhomogeneous ��target�� or ��sausage��-shaped soft- tissue mass with a layering effect. Typical are also considered mesenteric vessels within the intestinal lumen (30). An abdominal CT scan may define the location, the nature of the mass, its relationship to surrounding tissues and, moreover, it may help staging the patient with suspected malignancy causing the intussusception.

Is also reported recently that abdominal CT is able to distinguish Batimastat between intussusception without a lead point including images of no proximal bowel obstruction, target-like or sausageshaped mass and layering effect from intussusception with a lead point providing characteristic images such as signs of bowel obstruction, bowel wall edema with loss of the classic three-layer appearance due to impaired mesenteric circulation (31). For these reasons, we suggest that all patients presenting with a clinical picture of intestinal obstruction should have an abdominal CT scan as a standard diagnostic procedure.