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Published on: March 5, 2016
[Surgical aspects of intussusception due to lymphoma in children]
Insights
Pediatric intussusception caused by lymphoma requires careful surgical management. Early diagnosis and appropriate resection or biopsy are key to successful chemotherapy and preventing relapse.
Area of Science:
- Pediatric Surgery
- Pediatric Oncology
- Gastrointestinal Oncology
Background:
- Intussusception secondary to lymphoma presents a diagnostic and therapeutic challenge in children.
- This study reviews seven pediatric cases of intussusception caused by lymphoma.
Observation:
- Patients underwent various surgical interventions including laparotomy, biopsies, ileal resection, hemicolectomy, and tumorectomy.
- Surgical approaches varied based on the nature and location of the intussusception and suspected lymphoma.
Findings:
- All seven pediatric patients achieved successful treatment with protocol chemotherapy.
- No relapses were observed during follow-up periods ranging from 15 months to 13 years.
Implications:
- Awareness of ileal lymphoma as a cause of intussusception is crucial for pediatric surgeons.
- Limited intestinal resection and obtaining peripheral samples for diagnosis can optimize chemotherapy intensity and outcomes.
Background:
Intussusception due to lymphoma is a challenging condition for pediatric surgeons. The aim of this study is to report seven cases of this entity and to discuss its management.
Case Report:
Six boys and one girl, 3-15-years-old, were admitted for intussusception secondary to a lymphoma. All patients underwent laparotomy: biopsy of massive abdominal tumor 6 and 8 weeks following resection of an intussusception (two cases), ileal resection of non-reductible intussusception (one case), right hemicolectomy for tumor of the appendix (one case), tumorectomy of localized ileal tumor (two cases), enlarged mesenteric lymph node biopsy associated with simple reduction of intussusception (one case). All children were successfully treated with protocol chemotherapy with a 15-month to 13-year follow-up. No relapse was observed.
Conclusion:
Surgeons should be aware of operative sights of ileal lymphomas. Diagnosis of lymphoma may be difficult after manual reduction of intussusception. A sample of any abnormality (mesenteric lymph node, peritoneal fluid) should be taken. Intestinal resection allows to reduce the intensity of chemotherapy but must be as limited as possible: ileal resection in cases of complicated intussusception, tumorectomy "in sano" in cases of ileal parietal isolated tumor. Reduction of intussusception alone (with no resection of ileal tumor) seems to be effective if diagnosis of lymphoma is possible from peripheral samples (peritoneal fluid, pleural effusion, mesenteric lymph node, bone marrow biopsy...).
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