Abstract
BackgroundIntussusception is the most common intestinal obstruction among infants and young children. Most of the pediatric cases are ileo-cecal, while jejuno-jejunal and ileo-ileal combined contribute only 2.5% of the cases.Case presentationA 5-day-old child presented with recurrent non-bilious vomiting since birth. Physical examination revealed a slightly distended abdomen. A plain radiograph revealed a countable bubble appearance. The initial clinical diagnosis was gastric outlet obstruction. During surgery, we discovered multiple ileo-ileal intussusception associated with duodenal atresia. We manually reduced the intussusceptions and bypassed the duodenal atresia using Kimura’s procedure. We did not find any significant morbidity in the post-operative phase.ConclusionMultiple ileo-ileal intussusception rarely associates with duodenal atresia. In our case report, the intussusceptions might be indirectly caused by duodenal atresia through various pathophysiology. Other unusual findings also supported this suggestion.
Highlights
BackgroundIntussusception is the invagination of one part of the intestine into another
Intussusception is the most common intestinal obstruction among infants and young children
Duodenal atresia is associated with Down syndrome in 28.2% of the case, annular pancreas in 23.1% of the case, congenital heart disease in 22.6% of the case, malrotation in 19.7% of the case, esophageal atresiatracheoesophageal fistula in 8.5% of the case, genitourinary malformations in 8.0% of the case, anorectal malformations in 4.4% of the case, another bowel atresia in 3.5% of the case, and other anomalies in
Summary
Intussusception is the invagination of one part of the intestine into another It is the most frequent cause of intestinal obstruction among infants and toddlers between 6 and 18 months of age [1,2,3]. Duodenal atresia is a congenital anomaly and one of the most common causes of fetal bowel obstruction [4]. The incidence of this anomaly varies between 1 in 6000 and 1 in 10,000. We report a case of duodenal atresia associated with multiple ileo-ileal intussusception. A type 1 duodenal atresia and a total of 4 intussusception sites (Fig. 2) were found. Anal dilation using the examiner’s finger was required to initiate defecation; once the patient was able to defecate spontaneously, anal dilation was no longer performed
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