Postoperative intussusception after surgery for malrotation and appendicectomy in a newborn

Abstract

Postoperative intussusception in the newborn is an infrequent condition. A 17-day-old female with duodenal stenosis and malrotation underwent excision of the membrane in the duodenum and incidental appendicectomy. Postoperatively, a ceco-colic type of intussusception occurred, necessitating a right hemicolectomy. We speculate that the causative factors are twofolds: the embedded appendiceal stump, a polyp-like protrusion that became a lead point, and the non-fixation of the ileocecal mesentery, which facilitated a ceco-colic type of invagination.

Colocolic intussusception in a preterm infant with intestinal malrotation

“…Almost all the reported cases of Waugh syndrome have an ileocecal intussusception. Tatekawa et al [4] reported that the mobile cecum associated with malrotation may be the contributing factor for development of ileocecal intussusception. Our case demonstrated the very rare occurrence of a colocolic intussusception in a malrotated intestine where the lead point was an intestinal lymphangioma, the first reported case in the English literature.…”

Waugh’s syndrome: report of two cases

“…3,4 Tatekewa et al 3 suggested that the mobile cecum is associated with malrotation, which suspected to be factor allowing the terminal ileum to pass into the distal colon. Kidd et al 4 found 7 postoperative intussusception cases after the Ladd procedure in a large institutional series and suggested that the Ladd procedure predisposes children to postoperative intussusception.…”

Ileocecal intussusception following appendectomy

“…Plausible theories include local spasm or edema of the bowel wall, prolonged anesthesia with electrolyte imbalance, abnormal postoperative peristalsis, chemotherapy, radiation and bowel ischemia. 4 , 5 , 7 Potential leading points may be the anastomotic suture line, an appendiceal stump or the presence of intestinal tubes. 5 , 6 , 7 , 8 The etiology of intussusception following appendectomy is, however, not completely understood.…”

“…4 , 5 , 7 Potential leading points may be the anastomotic suture line, an appendiceal stump or the presence of intestinal tubes. 5 , 6 , 7 , 8 The etiology of intussusception following appendectomy is, however, not completely understood. Invagination of the stump may be associated with a small abscess which in turn may act as a lead point of intussusception, 9 but cases of cecocolic intussusception have been reported in which the stump was not inverted.…”

“…6 , 9 Abnormalities of rotation of the intestine have also been implicated in the etiology and the resulting mobile cecum may predispose to intussusception of the appendiceal stump. 7 While intussusception following appendectomy could be a consequence of an inverted appendicular stump forming the leading point, it is most often idiopathic. 1 , 5 …”