Abstract
In pediatric age group, Intussusception is the most common cause of acute intestinal obstruction. They present with the classic clinical triad of colicky abdominal pain, vomiting and bloody stools. But clinically very few patients (20%) present with this classical symptoms. This article highlights an importance of suspecting intussusception by physician and rare presentations of intussusception lump in abdomen in a child with abdominal pain, gastrointestinal symptoms. Here a case reported of 16-year-old male child who presented with migrating lump in abdomen on and off with varied clinical presentation every time in single admission. Patient underwent laparotomy and manual reduction of intussusception was done. It is advisable to have high suspicion of intussusception while dealing with such cases.
Highlights
Intussusception develops when a proximal segment of the gastrointestinal tract telescopes into a distal portion
Ileo cecal region of intestine and ascending colon along its mesentery fail to fuse to posterior parietal peritoneal wall, it is labelled as Hypermobile cecum and ascending colon, which has been noted in 10 - 20 percent of population [4]
In cases with confusing symptoms, contrast enhanced tomography (CT) scan of abdomen has helped to diagnose intussusception preoperatively identified with pathognomic appearance as a “sausage shaped mass” and typical “target sign” when the CT beams are perpendicular to longitudinal axis
Summary
Intussusception develops when a proximal segment of the gastrointestinal tract telescopes into a distal portion. Ileo cecal region of intestine and ascending colon along its mesentery fail to fuse to posterior parietal peritoneal wall, it is labelled as Hypermobile cecum and ascending colon, which has been noted in 10 - 20 percent of population [4]. Though this abnormal embryology is noted at high incidence, it rarely presents as a cause of recurrent abdominal pain. If the diagnosis of cecal volvulus is delayed, it requires emergency surgical intervention
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