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.