Concurrent acute appendicitis and ileocolic intussusception in a 1-year-old child

Abstract

Intussusception and acute appendicitis are part of a differential diagnosis for acute abdominal pain and vomiting in the pediatric population. We describe a unique case combining appendiceal intussusception with concurrent acute appendicitis, or “appendi-sception.” A 1-year-old boy presented with 1 day of fussiness, vomiting, and red, gelatinous stool. Initial diagnosis on ultrasound was a routine ileocolic intussusception with nonvisualization of the appendix. However, after a failed air enema decompression, the patient was taken to the operating room where the appendix was discovered to be inflamed within the intussusceptum. This case is unique as few cases of both conditions occurring simultaneously have been previously described. It is important for radiologists to be aware of this combination of diagnoses as both require urgent evaluation and prompt treatment.

Appendix around Ileocolic Intussusception with Acute Appendicitis

“…Concurrent occurrence of intussusception and acute appendicitis may be either due to intussusception causing strangulation and inflammation of the appendix or the inflamed appendix acting as a lead point for ileocolic intussusception. [ 5 ] Ultrasonography is the modality of choice for the diagnosis of intussusception and its bowel complications or for the identification of lead point. [ 6 ] Appendix involvement in intussusception must be ruled out when appendix is not visualized on high-resolution ultrasonography in cases with ileocolic intussusception.…”

Association of meteorological parameters with intussusception in children aged under 2 years: results from a multisite bidirectional surveillance over 7 years in India

“…40 Intussusception and acute appendicitis are intestinal problems and some of intussusceptions have associated appendicitis. [41][42][43] The climate factors are unlikely to directly cause intussusception or intussusception in children. But the linkage between seasonality and meteorological parameters and acute intestinal conditions appears to be plausible, which may be mediated by intestinal and non-intestinal infections (including activation of latent viral infections), mucosal inflammatory changes, lymphoid hyperplasia, or motility alterations and dietary intake changes.…”

A case of concomitant intussusception and appendicitis managed at a regional hospital in Guyana

“…Other case reports of this condition, denominated as an ‘appendi-sception’ exist. 2,5 Obviously, when both conditions co-exist, the risk of peritonitis is greater and the urgency for surgical intervention is more acute.…”