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Small bowel tumours causing intussusception in childhood
Insights
Small bowel tumors caused 3.5% of intussusception cases in children, often in older patients. These cases frequently required bowel resection and had poorer outcomes compared to idiopathic intussusception.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Oncology
Background:
- Intussusception is a common surgical emergency in children.
- Small bowel tumors are a rare but serious cause of intussusception.
Purpose of the Study:
- To investigate the incidence and characteristics of intussusception caused by small bowel tumors in a pediatric cohort.
- To compare outcomes of tumor-related intussusception with idiopathic intussusception.
Main Methods:
- Retrospective review of 292 children with intussusception.
- Analysis of tumor type, location, patient age, and treatment outcomes.
Main Results:
- Ten cases (3.5%) of intussusception were attributed to small bowel tumors.
- Patients with tumor-related intussusception were older on average (7/10 > 2 years).
- Peutz-Jeghers hamartomas caused jejunojejunal intussusception; other tumors were in the terminal ileum. Most cases required bowel resection due to irreducibility or gangrene.
Conclusions:
- Small bowel tumors are an important differential diagnosis for intussusception in older children.
- Tumor-related intussusception often presents with severe complications necessitating surgical intervention.
- While rare, prompt diagnosis and management are crucial, with lymphosarcoma associated with mortality in this series.
Abstract:
In a series of 292 children with intussusception ten (3.5 per cent) were caused by small bowel tumours. The average age of these patients was greater than in idiopathic cases; seven of the ten being older than 2 years. Intussusception due to Peutz-Jeghers hamartomas was jejunojejunal whereas other small bowel tumours causing intussusception were in the terminal ileum. The majority of these intussusceptions were either irreducible or gangrenous and all required resection of bowel. There was only one death in the entire series of 292 patients, and this was a child with lymphosarcoma.