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335319

Sphacelation with auto-anastomosis of the intestine: a rare outcome of intussusception in a child—a case report

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Last updated: 29 Dec 2024

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Abstract

Background
Intussusception is the telescoping of a proximal segment of the bowel into a distal segment. It can be idiopathic or pathological. Children commonly present with colicky abdominal pain, vomiting, a palpable abdominal mass, and bloody stools. Our case describes the unusual presentation of bowel sphacelation with auto-anastomosis in a child with intussusception and its clinical progression.
Case presentation
A 3-year-old boy with underlying stage IV rhabdomyosarcoma of the left orbit presented with high-grade fever and diarrhea for 1 day. He was treated for neutropenic sepsis in view of low absolute neutrophil count and recent history of chemotherapy. During his admission, he developed abdominal distension, high bilious aspirates, and diarrhea with bloody stools. Abdominal X-ray showed dilated bowel loops. Impression was septic ileus with coagulopathy. He was treated with blood transfusion and bowel rest. On the 6th day of illness, he passed out a tubular structure per rectum which was confirmed to be a segment of gangrenous bowel by histopathological examination. A diagnosis of intussusception with bowel sphacelation was made. He was treated conservatively, and his obstruction was resolved. He was discharged well with no abdominal symptoms during follow-up.
Conclusion
Intussusception is a common cause of small bowel obstruction in children. A high index of suspicion of intussusception should be maintained in children presenting with vomiting and bloody stools complemented by ultrasound to avoid missing this diagnosis. Sphacelation of the intussuscepted bowel with auto-anastomosis is a rare presentation of intussusception with a favorable outcome.

DOI

10.1186/s43159-021-00103-w

Keywords

Intussusception, Gangrene, Sphacelation, Bowel auto-anastomosis, Case Report

Authors

First Name

Shung Ken

Last Name

Tan

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Email

ken4376@hotmail.com

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Orcid

0000-0001-8603-8824

First Name

Chee Wei

Last Name

Tan

MiddleName

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Affiliation

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Email

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City

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Orcid

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First Name

Junaidah

Last Name

Hassan

MiddleName

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Orcid

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First Name

Mohan Arunasalam

Last Name

Nallusamy

MiddleName

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Affiliation

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Email

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Orcid

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First Name

Jian An

Last Name

Boo

MiddleName

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Email

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City

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Orcid

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First Name

Pavitratha

Last Name

Puspanathan

MiddleName

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Orcid

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Volume

17

Article Issue

1

Related Issue

45423

Issue Date

2021-02-01

Receive Date

2021-05-25

Publish Date

2021-08-23

Print ISSN

1687-4137

Online ISSN

2090-5394

Link

https://apsj.journals.ekb.eg/article_335319.html

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https://apsj.journals.ekb.eg/service?article_code=335319

Order

335,319

Publication Type

Journal

Publication Title

Annals of Pediatric Surgery

Publication Link

https://apsj.journals.ekb.eg/

MainTitle

Sphacelation with auto-anastomosis of the intestine: a rare outcome of intussusception in a child—a case report

Details

Type

Article

Created At

20 Dec 2024