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Burkitt's lymphoma as a pathological lead point in pediatric intussusception: A case report
Ahmed Hadj Taieb1, Mohamed Ali Chaouch1, Ramzi Beltaifa2
1Department of Visceral and Digestive Surgery, Monastir University Hospital, Monastir, Tunisia.
Background And Importance:
Intussusception is the invagination of one segment of the bowel into an adjacent segment, commonly causing bowel obstruction in pediatric patients. Although typically idiopathic, it can occasionally result from pathological lead points such as Burkitt's lymphoma. This case report details an unusual instance of ileocecal Burkitt's lymphoma presenting as ileocolic intussusception in a 14-year-old boy, managed surgically.
Case Presentation:
A 14-year-old male with no significant medical history presented with right iliac fossa pain for 48 h, without fever, bowel disturbance, or vomiting. Physical examination revealed tenderness and a palpable mass in the right iliac fossa. Ultrasonography confirmed ileocolonic intussusception. Conservative treatment with ultrasound-guided hydrostatic reduction failed, leading to an abdominal CT scan, which identified an 8 cm cecal mass causing the intussusception. The patient underwent laparoscopic surgery, revealing ileocecal intussusception with multiple mesenteric lymphadenopathies. A right hemicolectomy with ileocolic anastomosis was performed. Histopathology confirmed Burkitt's lymphoma. The patient was referred for chemotherapy and recovered uneventfully postoperatively.
Clinical Discussion:
Intussusception can occasionally be secondary to pathological conditions such as Burkitt's lymphoma. Gastrointestinal involvement in Burkitt's lymphoma is rare but can present diagnostic challenges, mimicking acute appendicitis or bowel obstruction. Diagnosis involves imaging modalities like ultrasound and CT, with tissue histopathology confirming the diagnosis. Complete surgical resection followed by chemotherapy is crucial for improved survival outcomes.
Conclusion:
Burkitt's lymphoma should be considered in pediatric intussusception cases, particularly when conservative management fails. Surgical intervention is essential for the diagnosis and management of intussusception caused by underlying malignancies. Early diagnosis and comprehensive treatment, including surgery and chemotherapy, are imperative for favorable outcomes.
