2012, Number 6
Jejunal intussusceptions as a lead point ectopic pancreatic tissue in a 1-year-old male. Case report
PDF size: 177.23 Kb.
ABSTRACTBackground: intussusception is the most common cause of acute bowel obstruction in infants and young children. Incidence has been reported as 1.5 to 4 cases per 1,000 live births. Most intussusceptions are ileocecocolic. jejunal intussusceptions in children is extremely rare
Clinical case: a 1-year-old male was admitted to the emergency department which diarrhea evacuations, without mucus or blood, craying and irritable. Previously had melaena in one occasion. The abdomen was found soft and depressible and low pain. He was treated with ceftriaxone, omeprazole and metoclopramide. Two days after admission had melaena and rectal bleeding. Plain abdominal radiography showed air fluid levels. Abdominal surgery was performed finding jejunal intussusceptions who was reduced. Demonstrable lesion as a lead point was a small tumor that was removed. Pathologist report pancreatic islets cells.
Conclusions: jejunal intussusceptions in children is extremely rare and occur at any age. Main symptoms are intermittent abdominal pain and vomiting. Ultrasonography is the study of choice. Often has a demonstrable lesion as a lead point for the intussusceptions therefore requires open or laparoscopic surgery. Is unusual the presence of ectopic pancreatic tissue as a lead point.
Fischer TK, Bihrmann K, Perch M, Koch A, Wohlfahrt J, Kare M, et al. Intussusception in early childhood: a cohort study of 1.7 million children. Pediatrics 2004;114(3):782-785.
Ross JG, Potter CW, Zachary RB. Adenovirus infection in association with intussusception in infancy. Lancet 1962;2(7249):221-223.
Konno T, Suzuki H, Kutsuzawa T, Imai A, Katsushima N, Sakamoto M, et al. Human rotovirus infection in infants and youn children with intussusceptions. J Med Virol 1978;2(3):265-269.
Gorenstein A, Raucher A, Serour F, Witzling M, Katz R. Intussusception in children: reduction with repeated, delayed air enema. Radio-logy 1998;206:721-724.
Bines JE. Rotavirus vaccines and intussusception risk. Curr Opin Gastroenterol 2005;21:20-25.
Huppertz HI, Soriano-Gabarro M, Grimprel E, Franco E, Mezner Z, Desselberger U, et al. Intussusception Among Young Children in Europe. Pediatr Infect Dis J 2006;25:S22-S29.
Kombo LA, Gerber MA, Pickering LK, Atreya CD, Breiman RF. Intussusception, Infection, and Inmunization: Summary of a Workshop on Rotavirus. Pediatrics 2001;108(2):E37.
Ein SH, Alton D, Palder SB, Shandling B, Stringer D. Intussusception in the 1990s: has 25 years made a difference? Pediatr Surg Int 1997;12(5-6):374-376.
Pracros JP, Tran-Minth VA, Morin de Finfe CH, Deffrenne-Pracros P, Louis D, Basset T. Acute intestinal intussusception in children. Contribution of ultrasonography (145 cases). Ann Radiol (Paris) 1987;30(7):525-530.
Tellado MG, Liras J, Méndez R., Somoza I, Sánchez A, Maté A, et al. Ultrasound-guided hydrostatic reduction for the treatment of idiopathic intestinal invagination. Cir Pediatr 2003;16(4):166-168.
Calder FR, Tan S, Kitteringham L, Dykes EH. Patterns of manegment of intussusceptions outside tertiary centers. J Pediatr Surg 2001;36(2):312-315.
Sherman JO, Consentino CM. Intususcepcion. In: Keith W Ashcraft, Thomas M Holder, editors. Cirugía Pediatrica. México: McGraw- Hill, 1995 p. 429-433.
Stone DN, Kangarloo H, Graviss ER, Danis RK, Silberstein MJ. Jejunal intussuception in children. Pediatric Radiology 1980;9(2):65-68.
Yazbeck N, Mahfouz I, Majdalani M, Tawil A, Farra C, Akel S. Intestinal polypoid arteriovenous malformation: unusual presentation in a child and review of the literatura. Acta paediatric Acta Paediatr 2011;100(9):e141-144.
Park HS, Lee H, Moon WS, Lee SC, Choi WB, Choi HW. Intussusception secondary to jejunal lymphangioma in a 13-year-old girl. Korean J Gastroenterol 2007;49(4):256-259.
Oshita M, Okazaki T, Yamataka A, Kusafuka J, Lane GJ, Matsumoto T, et al. Jejuno-jejunal intussusception secondary to submucosal lymphangioma in a child. Pediatr Surg Int 2005;21(12):1001-1003.
Hadley GP, Sharma S. Neonatal intussusception. P N G Med J 1893;26(2):144-145.