Post-operative ileo-ileal intussusception one week after hemicolectomy for ileo-colic intussusception

Abstract

Intussusception is a common pediatric surgical emergency that results from the introversion of one loop of bowel into another. It is common in children between 3 months and 3 years. Recurrence of intussusception is said to be common in non-operative reduction and negligible after operative reduction. In this case report, we aim to discuss a case of post-operative ileo-ileal intussusception (POI) 7 days after a laparotomy and resection on account of gangrenous ileo-colic intussusception. A 13-month-old male patient presented with bloody stools associated with abdominal distention and fever. Clinical findings were suggestive of intussusception. Diagnosis was confirmed with an abdominopelvic ultrasound. A laparotomy revealed a gangrenous ascending colon extending to the terminal ileum so a right hemicolectomy was performed. The patient was well until post-operative day 7 when he developed abdominal distention associated with vomiting. An abdominal x-ray revealed multiple air fluid levels. A re-laparotomy was performed and a new intussusception was found proximal to an intact and patent anastomotic site. The involved bowel was reduced because it was viable. He was discharged on post-operative day 14. This was a rare case of recurrent intussusception with resection and anastomosis on account of intussusception in a 13-month-old boy.