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Intussusception in preterm infants: case report and literature review
U Görgen-Pauly1, C Schultz, M Kohl
1Department of Paediatric Surgery, Medical University of Lübeck, Lübeck, Germany.
Insights
Intussusception is rare in preterm infants but requires prompt diagnosis. Early recognition of symptoms like abdominal distension is crucial to prevent surgical complications.
Area of Science:
- Neonatal Medicine
- Pediatric Surgery
Background:
- Intussusception is a rare but serious condition in preterm infants.
- This report details a case in a 29-week gestational age infant and reviews 17 prior cases.
Observation:
- Common clinical signs include severe abdominal distension, gastric aspirates, and bloody stools.
- A palpable abdominal mass is a less frequent finding.
- Radiographic signs of small bowel obstruction are key diagnostic indicators.
Findings:
- Risk factors for intussusception in preterm infants appear multifactorial.
- Symptoms often mimic necrotizing enterocolitis, complicating diagnosis.
- Diagnosis delays averaged 7 days, increasing risks of bowel compromise.
Implications:
- Consider intussusception in preterm infants presenting with acute abdominal distension and tenderness.
- Timely diagnosis and surgical intervention are vital to improve outcomes.
- Differentiating intussusception from necrotizing enterocolitis is critical for appropriate management.
Unlabelled:
Intussusception is an extremely rare disorder in preterm infants. An infant of 29 weeks gestational age with this condition is reported and a retrospective analysis of 17 previously reported cases presented. In the reviewed preterm infants, risk factors for intussusception seemed to be multifactorial. Clinical features included severe abdominal distension (17/17), gastric aspirates (13/17), commonly bilious, bloody stools (10/17) and rarely a palpable abdominal mass (5/17). Diagnostic features were signs of small bowel obstruction on the abdominal radiographs. Signs and symptoms were similar to those seen in necrotizing enterocolitis, therefore difficulties in establishing a correct diagnosis led to an average delay of 7 days between the onset of symptoms and abdominal surgery, increasing the risk of developing a compromised bowel.
Conclusion:
The differential diagnosis of an intussusception should be considered in preterm infants with acute abdominal distension and tenderness.