Recurrent Intussusception in the Setting of Meckel's Diverticulum in an Infant.

Intussusception is a condition consisting of a proximal portion of the bowel contracting into a more distal bowel portion. The recurring act of intussusception is typically caused by a pathological lead point persisting within the bowel. The most common lead point for intussusception is a Meckel's diverticulum, which arises due to the incomplete obliteration of the omphalomesenteric canal causing a true diverticulum in the small bowel. This report outlines a case of a 10-month-old male infant who experienced three intussusception episodes, eventually requiring surgical intervention. A clinician's awareness of this phenomenon aids in implementing adequate treatment.

Adenovirus infection is a risk factor for recurrent intussusception in pediatric patients.

BACKGROUND: Human adenoviruses are the most common pathogens to be isolated from cases of pediatric intussusception. However, the specific clinical characteristics of pediatric intussusception associated with adenovirus infection are poorly known. METHODS: We reviewed the medical records of pediatric patients (≤18 years of age) with intussusception treated between January 2014 and December 2020. We enrolled patients with febrile episodes, 27 with and 29 without adenovirus infections (the latter serving as control group). The demographic data, clinical characteristics, and the diagnoses and management strategies were evaluated. RESULTS: The adenovirus group exhibited a significantly longer febrile duration (4.3 ± 1.9 vs. 3.3 ± 1.1 days, p = 0.020) than the control group, with an odds ratio (OR) of 5.098 (95% confidence interval [CI] 1.223-21.254, p = 0.025). The recurrence rates were 48.1% and 13.8% in the two groups (OR 5.804; 95% CI: 1.585-21.245, p = 0.008). Most adenoviruses were non-enteric (85.2%). CONCLUSION: Adenovirus-related intussusception is associated with a longer febrile period and a higher rate of intussusception recurrence. It is recommended that patients suspected of adenovirus-related intussusception should be observed for longer than others prior to discharge.

Intussusception Caused by Peutz-Jeghers Syndrome.

A 20-year-old female patient with a family history significant for Peutz-Jeghers syndrome presented to the hospital multiple times with complaints of abdominal pain. On the initial visit to the hospital, the patient underwent small bowel resection for small bowel obstruction secondary to intussusception, following which she visited the hospital again one year later for similar complaints and underwent reduction of multiple points of intussusception of the small bowel without any resection of the same. Eventually, the patient underwent resection of the small bowel for the second time, along with tumor resections. The importance of follow-up in patients with Peutz-Jeghers is particularly essential, in part, because it is vital to monitor the tumors, their size, and number to prevent surgical intestinal complications, anemia, and also to eventually monitor for carcinomatous changes.

Is There a Causal Relationship between Intussusception and Food Allergy?

Although intussusception and food allergy are common health problems in childhood, the relation between these two diseases remain obscure. The aim of this study is to investigate the relationship between food allergy and intussusception, and the factors associated with both. Patients diagnosed with intussusception by the Brighton Collaboration Intussusception Working Group criteria were prospectively investigated for food allergy per the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Guideline. They were analyzed per demographic features, clinical, physical and laboratory findings. There were eight (38.1%) patients diagnosed with food allergy, while 13 (61.9%) patients were non-allergic. The mean number of days of presenting symptoms was 1.13 days in the allergy group and 7.85 days in the non-allergy group. The mean number of intussusception attacks was 1.63 in the allergy group while 1 in the non-allergy group (p < 0.05, relative risk (RR) = 2.6). In the allergy group, one (13%) patient was followed up, six (75%) patients were reduced with pneumatic and one (13%) patient reduced manually. In the non-allergy group, four (31%) patients were followed up, six (46%) patients were reduced with pneumotic, one (7%) patient was reduced manually, and resection anastomosis was performed in two (15%) patients. Food allergy is an unrecognized associated factor for intussusception patients, which increases the risk for recurrence. Due to the small patient population, these results should be interpreted with caution.

Invaginación intestinal recurrente secundaria a apéndice cecal invaginado: caso clínico / Recurrent intussusception secondary to invaginated cecal appendix. Case report

Introducción: La invaginación intestinal es una patología de causa idiopática en el 95 por ciento de los casos, encontrándose en el 5 por ciento restante algún factor desencadenante que la justifique. Las recurrencias se presentan en un 7 a 12 por ciento de los casos y se asocian a múltiples causas. El objetivo de este trabajo es presentar el caso de un paciente con invaginación intestinal recurrente y analizar la causa de la recurrencia. Caso clínico: Paciente de 1 año y 4 meses de edad, sexo masculino, con antecedente de primer episodio de Invaginación intestinal operado a los 4 meses de edad. Presenta segundo episodio de invaginación a los 9 meses de edad, la cual se trató con desinvaginación neumática y a los 16 meses de edad presentó su tercer episodio, manejandose con desinvaginación hidrostática. Ocho horas post procedimiento el paciente presentó nueva invaginación; se realizó reducción manual quirúrgica. Se encontró una invaginación ileocólica con un remanente apendicular intracecal actuando como cabeza invaginante. Se reseco remanente y se envió a biopsia. Conclusiones: La invaginación intestinal recurrente se asocia a factores anatómicos desencadenantes, por lo cual al presentar recurrencias se debe tener en consideración una posible causa orgánica, ante lo cual se recomienda el tratamiento quirúrgico.

Introduction: Intussusception is an idiopathic pathology that accounts for 95 percent of cases found; the remaining 5 percent is caused by some triggering events. Recurrences occur in 7 to 12 percent of cases and are associated with multiple causes. The aim of this research is to present the case of a patient with recurrent intussusception and analyze the cause of the recurrence. Case report: The patient was a 16 month-old male infant with a history of first episode of intussusception surgery at 4 months old. His second intussusception episode took place at 9 months of age, which was treated with pneumatic reduction process; at 16 months of age he presented his third episode, which was treated with hydrostatic reduction process. 8 hours post procedure, the patient had a new intussusception condition and surgical manual reduction was performed. Ileocolic intussusception was found with an appendiceal intrathecal remnant acting as the invaginating head. Remnant was removed and sent for biopsy. Conclusions: Recurrent intussusception is associated with triggering anatomical factors; therefore, in the case of recurrences, a possible organic cause should be considered and surgical treatment is recommended.

Clinical Analysis of Recurrent Intussusception and the Pathologic Lead Point in a Single Center / 대한소아소화기영양학회지

PURPOSE: Intussusception is the most common cause of intestinal obstruction in young children. Although intussusceptions are easily treated, some intussusceptions with or without a pathologic lead point (PLP) often recur. In this study, we analyzed the clinical characteristics and prognosis of recurrent intussusceptions (RI), the frequency of the PLP, and correlation between RI with PLP. METHODS: The medical records of 144 patients, among 590 patients with intussusceptions who had been admitted to the Department of Pediatrics and Pediatric Surgery of Dankook University Hospital between May 1994 and June 2009 were reviewed retrospectively. RESULTS: The overall recurrence rate of intussusceptions in this study was 9.2%. The mean interval between the initial occurrence and the first recurrent attack was 130+/-175 days (range, 12 hours to 3 years). There was no statistically significant difference in the recurrence rate among patients who underwent air, barium, and manual reduction (p=0.131). Eighty-seven cases (92.6%) of RI had a successful reduction by the use of non-operative techniques. A PLP was present in 18 patients (3.0%). The most common PLP was intestinal lymphoid hyperplasia, followed by Meckel's diverticulum, duplication cyst, intestinal polyp, and adenomyoma. The mean number of intussusceptions was 4.7+/-1.9 in 7 patients with PLP, which was significantly higher than (2.4+/-0.9) patients without a PLP (p=0.023). The mean duration of recurrences was 17.4+/-19.8 months (range, 2 days to 72 months). CONCLUSION: A careful search for a PLP should be performed to prevent recurrence of intussusception, especially when intussusception has recurred more than three times.

Post operative recurrent acute jejuno-jejunal intussusception.

A case of recurrent acute jejuno-jejunal intussusception presenting in the post operative period of the surgery for acute ileocolic intussusception is presented. Post operative intussusception is defined as intussusception occurring within 30 days of the primary surgery [1]. This is a rare entity. Jejuno-jejunal intussusception is also rare. Recurrent intussusception is uncommon. The present case is a combination of all these rarities.

Small Intestinal Mucosa Associated Lymphoid Tissue (MALT) Lymphoma in a Child Presenting with Recurrent Intussusception: A Case Report

Mucosa associated lymphoid tissue (MALT) lymphoma is a malignant B cell lymphoma that develops from MALT. The stomach is the most common site of MALT lymphomas but be found anywhere in the body. Adult MALT lymphomas are not rare diseases, but in children, intestinal MALT lymphomas are very rare. We treated a 12-year-old boy who underwent segmental resection of the small intestine due to recurrent intussusceptions, 2 months apart, and was diagnosed with an intestinal MALT lymphoma. He received multiple chemotherapeutic agents (vincristin, cyclophosphamide, prednisone, methotrexate, doxorubicin and cytosine arabinoside) according to the CCG-5961 protocol for 3 months. Currently, he is alive and disease free.

A Case of Recurrent Transient Small Bowel Intussusception / 대한소아소화기영양학회지

Isolated small bowel intussusception accounts for 10% of all pediatric intussusception. It is more common in children older than 2 years of age. Presentation usually is with vomiting and abdominal pain. Currant jelly stool and palpable mass are less frequent than typical intussusception. There are few reported cases of children with transient small bowel intussusception. We describe 3-year-old boy presented with intermittent cyclic crampy abdominal pain for 6 months was diagnosed as having recurrent transient small bowel intussusception by abdominal ultrasonography and small bowel series.