A case of dual segment intussusception(ileocolic and jejunal jejunal): Dilemma for surgeons and radiologists

Abstract

Intussusception is defined as a process in which a segment of bowel invaginates into the adjoining intestinal lumen, causing bowel obstruction. With early diagnosis, appropriate fluid resuscitation, and therapy, the mortality rate from intussusception in children is less than 1% (Bothara et al., 2018) [1]. Intussusception is a common surgical emergency in paediatric age group. Typically patients presented with generalized abdominal pain with bloody stool. Initial resuscitation will be the first line management. Ultra-sonography (USG) is an important investigation for diagnosing intussusception [2]. It has numerous advantages like absence of harmful radiation exposure to the children, lead point identification and ability to diagnose ileo-ileal and other small bowel intussusceptions (1). Radiologist also provide therapeutic approach by fluoroscopic/ultrasound guided contrast or water reduction. The role of surgery only reserved if recurrent intussusception despite multiple reduction radiologically or in case of suspicious of intestinal perforation with peritonitis. Jejunal intussusception is a rare condition. In contrast to the typical case of ileocolic intussusception, a '''lead point” is commonly found that is usually ectopic gastric mucosa.

Keywords

• Jejunal jenunal intussusception
• Dual segment
• Fluoroscopy guided reduction
• Laparascopic reduction
• Recurrent intussusception