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:
- Meckel diverticulum (the most common lead point)
- Intestinal duplication (relatively rare)
- Benign polyps
- Malignant lymphoma
- Peutz–Jeghers syndrome
- and hamartoma (n = 1).
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