Double small bowel intussusception complicating bilateral partial nephrectomies

Abstract

An 11.5-month-old male, diagnosed with bilateral Wilms tumor at 10 months of age, received 6 weeks of chemotherapy and subsequently underwent bilateral partial nephrectomies. On postoperative day 5, he had crampy abdominal pain and bilious vomiting. Abdominal ultrasound confirmed the presence of an intussusception in the right lower quadrant. Laparotomy demonstrated two separate areas of small intestinal intussusception located at jejuno-jejunal and ileo-ileal locations. The patient was successfully treated with manual reduction. A high index of suspicion is necessary to diagnose and treat patients with two different points of intussusception.

Double simultaneous intussusception caused by Meckel’s diverticulum and intestinal duplication in a child

“…The most useful sign of a physical check-up is an abdominal mass. An abdominal mass was apparent in less than half of the reported cases of double intussusception 6,8,10,11,13,16 and none of them presented as two palpable masses. Some of these patients can have abdominal tension and increased bowel sounds.…”

“…Only 14 cases of double intussusception have been reported. [4][5][6][7][8][9][10][11][12][13][14][15][16][17] Double simultaneous intussusception may be mainly attributed to an explicit lead point, the idiopathic status, or even the postoperative status. The lead point is the main factor, including a patent vitellointestinal duct, heterotopic pregnancy, ileal polyp, angiolipoma, lipoma, and Peutz-Jeghers syndrome.…”

“…To date, only 14 cases of double intussusception (Table 1) have been reported. [4][5][6][7][8][9][10][11][12][13][14][15][16][17] Occurrence of double simultaneous intussusception with two explicit leading points has not been previously reported.…”

Two simultaneous intussusceptions in a neonate with DiGeorge syndrome: A case report

“…Intussusception in neonates can be idiopathic or associated with a pathological lead point such as inspissated meconium, duplication cyst, Meckel's diverticulum, hamartoma, polypoid masses, etc. [4,5] In premature neonates, small bowel intussusception is the commonest type for which intestinal hypoperfusion, hypoxia, and dysmotility may be the contributory factors. Lead point is seen in only 5-8% of neonates.…”