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[An unusual care of intestinal invagination: jejunojejunal invagination]
N Chavanis1, B Boumahni, C Jacquier
1Service de chirurgie pédiatrique générale, CHU de Grenoble, France.
Insights
Jejunal intussusception, rare in children over 2, often presents atypically. A case highlights a polyp in ectopic gastric mucosa as the cause, necessitating surgical intervention for this uncommon condition.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Jejunal intussusception is a rare form of bowel obstruction, distinct from the more common ileocolic intussusception.
- It typically affects children older than two years and may present with atypical, subacute symptoms.
- An underlying anatomical abnormality is frequently identified as the cause.
Observation:
- A 14-year-old male presented with abdominal pain and bilious vomiting.
- Physical examination was unremarkable, but ultrasonography revealed jejunal intussusception.
- Laparotomy confirmed the intussusception, which was irreducible, leading to resection and anastomosis.
Findings:
- Histopathological examination of the resected specimen identified a polyp composed of ectopic gastric mucosa.
- This finding points to a specific, though unusual, cause of jejunal intussusception.
Implications:
- Jejunal intussusception requires increased clinical awareness due to potential diagnostic delays.
- Surgical exploration is the definitive treatment, essential for addressing the underlying anatomical cause.
- Ectopic gastric mucosa should be considered in the differential diagnosis of jejunal intussusception.
Background:
Jejunal intussusception is uncommon in comparison with ileocolic form. It is more frequent in children over 2 years of age and has an atypical subacute presentation. An underlying anatomical cause is usually found.
Case Report:
A 14-year-old boy was admitted for abdominal pain with bilious vomiting. The physical examination was normal, with only the ultrasonography showing an intussusception in the left hypochondrium. At laparotomy the diagnosis of jejunal intussusception was made; its reduction was impossible. A resection and end to end anastomosis was performed. The anatomopathology examination found a polyp in ectopic gastric mucosa.
Conclusion:
Jejunal intussusception must be better understood as its diagnosis could be made too late. Surgical exploration is the treatment of choice because of the usual underlying anatomical cause.