Prolapsed ileocolic intussusception in an infant: An uncommon presentation

Intussusception is a common pediatric emergency, although a prolapsed intussusception is a rare entity, often misdiagnosed as a rectal prolapse.We report a 10-month-old female baby who presented with a three week history of a mass protruding per anus and vomiting, and a 2 week history of bloody diar...

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Bibliographic Details
Main Authors: Jamil M. Suleiman, David Msuya, Murad Tarmohamed, Jay Lodhia
Format: Article
Language:English
Published: Elsevier 2021-11-01
Series:Journal of Pediatric Surgery Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213576621002499
Description
Summary:Intussusception is a common pediatric emergency, although a prolapsed intussusception is a rare entity, often misdiagnosed as a rectal prolapse.We report a 10-month-old female baby who presented with a three week history of a mass protruding per anus and vomiting, and a 2 week history of bloody diarrhoea. A clinical diagnosis of a prolapsed intussusception was made and no imaging studies were ordered to avoid a delay in management. The patient underwent an emergency laparotomy, where a dual reduction was done and the bowels were found to be ischemic hence a right hemicolectomy was performed with end-to-end ileo-transverse anastomosis. Unfortunately, 2 weeks post laparotomy, the patient presented with a high output enterocutaneous fistula. Another emergency laparotomy was performed, with findings of intestinal adhesions and an anastomotic leak. Adhesiolysis was done along with re-freshening of the ileo-transverse anastomosis.Intussusceptions presenting in the form of a prolapse through the anus is a rare condition indicating a serious sign and is often mistaken for a rectal prolapse. A digital rectal examination can help differentiate the two from each other. Surgery is the mainstay treatment for a prolapse intussusception, and should not be delayed.
ISSN:2213-5766