Potential of colonoscopy as a treatment for intussusception in children

Adult Left Colocolic Intussusception Successfully Managed by Left Hemicolectomy and Primary Anastomosis

Intussusception, although quite common in children with the classic triad of cramping abdominal pain, bloody diarrhea, and palpable masses, is a rare cause of acute abdomen with myriad presentations in adults. It is defined as the telescoping of a proximal segment of the gastrointestinal (GI) tract, called the intussusceptum, into the lumen of the adjacent distal segment of the GI tract, called intussuscipiens. Due to its different manifestations and time course, adult colonic intussusception often poses a diagnostic challenge for emergency doctors. The treatment of colonic intussusception in adults typically involves surgery, often with bowel resection and anastomosis followed by a defunctioning loop ileostomy. We report a case of left-sided colocolic intussusception secondary to a tubular adenoma as the lead point, which was successfully treated by resection and primary anastomosis. The pathological diagnosis of the lesion was reported as adenocarcinoma and resected bowel margins were found free of the tumor.

Colonoscopic reduction of a transanal prolapsed ileocolic intussusception

Transanal protrusion of intussusception (TAPI; also known as prolapsed intussusception) is a rare complication. Here, we present a successful colonoscopic reduction of ileocolic intussusception presented with transanal prolapse. An 8‑month male child, weighing 8 kg, was referred to our hospital presenting with a mass in his anal canal, diarrhea and rectal bleeding for two days. The sonographic evaluation revealed an ileocolic intussusception in the rectosigmoid area. The patient was treated using colonoscopic reduction. To our knowledge, this is the first study reporting colonoscopic reduction for transanal prolapsed intussusceptions. Our study suggests gastroenterologists to consider colonoscopy as a therapeutic method for prolapsed intussusceptions and encourages them to attempt reducing the invagination using this method before laparotomy, especially in cases presenting within 48 h of onset of symptoms and no peritonitis symptoms.

Cecal Intussusception Diagnosed by Total Colonoscopy in a Child: A Case Report

Background: Ileocolic intussusception is the most common form of intussusception in children. Intussusception in the appendix or cecum without a lead point in a child is very rare and was found with total colonoscopy (TCS) and computed tomography. Case Presentation: A 9 year-old boy was admitted to our hospital with fever, vomiting, and two episodes of bloody diarrhea. Inflammatory bowel disease was suspected; TCS was performed and revealed intussusception whose advanced region was in the cecum. The diagnosis was idiopathic cecum intussusception. This case was unusual in that intussusception had occurred at a young age but without lead point; in addition, the intussusception had also occurred at the tip of the cecum. The intussusception was safely reduced by endoscopic procedures, and after improvement in the vomiting, the patient was safely discharged and has had no bloody stools since. Conclusion: We demonstrated cecal intussusception without lead point observed on TCS in a child.