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Intussusception in a premature infant simulating necrotising enterocolitis
Insights
Intussusception can mimic necrotising enterocolitis in premature infants, presenting with vomiting and distension. Early diagnosis is crucial as intussusception requires prompt surgery, unlike necrotising enterocolitis.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
Background:
- Intussusception and necrotising enterocolitis (NEC) present with overlapping symptoms in neonates, including vomiting, guaiac-positive stools, and abdominal distension.
- Distinguishing between these conditions is critical due to differing management strategies: NEC requires delayed surgical intervention until perforation, while intussusception necessitates prompt surgical treatment.
Abstract:
Intussusception in older infants is manifested by bloody stools, colicky abdominal pain and a palpable abdominal mass. In neonates the symptoms are often restricted to vomiting, guaiac positive stools and abdominal distension. These symptoms closely mimic necrotising enterocolitis. Surgical treatment of necrotising enterocolitis should be postponed until perforation of the gastrointestinal tract has occurred, whereas, prompt surgical treatment is recommended for intussusception. We report a case of intussusception that simulated necrotising enterocolitis in a 740 grammes premature infant in the second week of life. The clinical and radiographic features are described and the difficulty in distinction between the two conditions is emphasised. Neonatologists and paediatric surgeons should always include intussusception in the differential diagnosis of abdominal distension and guaiac positive stools in small premature infants.