Abstract
Intussusception is a surgical emergency. If not immediately treated, it can lead to bowel wall perforation. In 2.2-15% of cases, they have pathologic lead points such as Intestinal duplication. This case report presents a rare tubular ileal duplication as a necrotic Ileoileal intussusception in a 4-year-old girl.Key Clinical MessageIn all children over three years old with intussusception suspicious to pathologic lead points and initially negative ultrasonography (US) results never exclude second repeat US.Keywords
Intussusception, Ileal duplication, Alimentary tract duplication
1 INTRODUCTION
Intussusception is one of the most frequent intestinal obstruction etiologies when a portion of the gastrointestinal tract gets telescoped into the near bowel segment. The most common type is the idiopathic ileocolic one (98%). This can happen in children ages six months and two years. in the past, it had high mortality and morbidity rates which, with the progress of diagnosis and effective treatment, came to a good outcome. In cases not immediately treated, bowel wall ischemia and perforation are probable, with an unfavorable prognosis. The classic symptoms that increase the clinical suspicion of it are a triad of vomiting, palpable abdominal mass, and passage of ”currant jelly stools” (stools mixed with blood and mucus).
in 2.2-15% of cases, they have pathologic lead points (PLPs) such as:
In non-complicated intussusception, radiological reduction is the treatment of choice, and the failure rate of it is 10-60 %. In these cases, surgical therapy is mandatory. Intestinal duplication is a rare congenital malformation (one in 10000 birth) and is defined as alimentary pathway duplication, mostly involving the midgut, especially the ileum. duplication by itself has many types. One of them is the tubular type, which may be short or involve entire segments, and it is rare. We herein report a rare case of a tubular ileal duplication as a complicated Ileoileal intussusception in a 4-year-old girl.
2 Case presentation