The dissection sign of nonreducible ileocolic intussusception

A retrospective study of 90 cases of ileocolic intussusception seen over a 5-year period was undertaken to identify features of failed hydrostatic reductions. A new, reliable sign of nonreducible intussusception was found: the dissection sign. Of the 90 cases, 23 demonstrated barium dissecting between the intussusceptum and intussuscipiens ; of those, nine had necrotic bowel found at surgery. All of the 23 cases with dissection failed hydrostatic reduction. Of the 23 patients, 22 were below age 2 years. None of those reduced by barium enema had dissection. The dissection sign on barium enema for ileocolic intussusception is an indication to discontinue hydrostatic reduction and to institute surgical treatment, especially in patients under age 2 years.