Appendix around Ileocolic Intussusception with Acute Appendicitis

Abstract

Intussusception and appendicitis share similar clinical features. However, their concurrent occurrence is exceedingly rare. Appendix involvement in intussusception must be ruled out when appendix is not visualized on high-resolution ultrasonography in cases with ileocolic intussusception. This case report describes the sonological appearance of a combination of ileocolic intussusception with concurrent acute appendicitis in a 4-year-old child.

Intussusception of the cecum due to the acute appendicitis: A case report

“…While intussusception of the appendix itself caused by appendicitis has been reported [16] , a search of the PubMed database using the keywords “intussusception” and “appendicitis” and “ileocolic” or “cecocolic” revealed only seven reports of cecocolic intussusception caused by appendicitis as a secondary disease from April 1955 to April 2022 (excluding conference proceedings and our case) [5] , [6] , [7] , [8] , [9] , [10] , [11] . Table 1 shows the eight reported cases of cecocolic intussusception caused by appendicitis, including the present case.…”

“…On the other hand, intussusception in adults is rare, accounting for only 5 % of all cases of intussusception in all ages; in most cases tumors are reported to be the leading point [3] , [4] . Therefore, intussusception caused by inflammatory disease is a rare condition with only a very small number of cases reported in the relevant literature [5] , [6] , [7] , [8] , [9] , [10] , [11] .…”

Ruptured Appendicitis Within an Intussusception on Point-of-Care Ultrasound

“…It is unclear in these cases whether the appendicitis develops as a result of compression and strangulation of the appendix trapped in the intussusception or whether the appendicitis acts as a lead point that causes the intussusception. [8][9][10][11][12] We report the first case, to our knowledge, of perforated appendicitis within an intussusception identified on POCUS.…”

“…In all but 1 of the cases initially diagnosed as intussusception on RADUS, the diagnosis of appendicitis as the lead point was made only after the patient failed reduction with pneumatic enema and was taken to the operating room. It is unclear in these cases whether the appendicitis develops as a result of compression and strangulation of the appendix trapped in the intussusception or whether the appendicitis acts as a lead point that causes the intussusception 8–12 . We report the first case, to our knowledge, of perforated appendicitis within an intussusception identified on POCUS.…”

“…Appendicitis within an intussusception is rare, and only a few cases in young children have been reported 8–13 . Point-of-care-ultrasound was used in only 1 case, and appendicitis (nonperforated) was a lead point for ileocolic intussusception 13 .…”