3 Discussion
Intussusceptions are usually idiopathic, and just in 2.2-15% of cases, they have pathologic lead points such as Meckel diverticulum (most common) and Intestinal duplication.
Most PLPs present as ileoileocolic intussusceptions (40%of all ileoileocolic),
generally, signs and symptoms are similar. Still, presentations can vary and
are often nonspecific because of the wide range of lesions or intestinal anomalies. PLPs should be considered, especially in the case of multiple recurrences and failure of enema technique reduction or children over five years.
We recommended in suspicious circumstances; a primarily negative US investigation should never exclude a second repeat US.
Enteric duplication is often in the ileum and may be either cystic or tubular. Unlike the Meckel diverticula, most are attached to the mesenteric portion and consist of two parts: an outer layer of smooth muscle and an inner lining of the gastrointestinal epithelium.
It should be embedded that many children may represent non-classic symptoms, so diagnostic evaluation depends on radiologic imaging to make the precise diagnosis. In the hands of a skilled examiner, ultrasound (US) is the choice for confirming or excluding intussusception and duplication in children with 98-100 % sensitivity and 88-100 % specificity. However, the computed tomography (CT) scan is the gold standard in adults, while in the US is more common.
Treatment of a stable patient with intussusception begins with an enema reduction in the emergency department; in the absence of contraindications such as perforation or shock signs, etc.
And the presented case came with the classic symptoms of intussusception that US findings boosted the suspicion. At the operation, the tubular type of ileal duplication, which is almost rare, was seen, and Ileoileal intussusception was approved.
We also searched extensively four databases of PubMed, Cochrane Library, Scopus, and Google Scholar with MeSH terms of the keywords of intussusception, duplication, ileal duplication, tubular duplication, and children with the 5-year time filter, English language filter, and no article type filters and for exclusion criteria, we omitted irrelevant studies. We found few cases of children with intussusception secondary to tubular ileal duplication.