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Concomitant ileocolic intussusception and perforated appendicitis in a toddler
Michael Grimm1, Hayley Harman1, Jonathan Gootee2
1School of Medicine, WVU, Morgantown, West Virginia, USA.
BMJ Case Reports
|April 23, 2025
Summary
A toddler with persistent abdominal pain was initially treated for intussusception but was later diagnosed with perforated appendicitis. This case highlights the need for ongoing evaluation and consideration of multiple diagnoses in pediatric abdominal pain.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Surgery
Background:
- Abdominal pain is a common presentation in children.
- Differentiating causes like intussusception and appendicitis can be challenging.
Purpose of the Study:
- To present a case of a toddler with a complex presentation of abdominal pain.
- To emphasize the importance of continuous evaluation and differential diagnosis in pediatric abdominal emergencies.
Main Methods:
- Case report of a toddler with initial symptoms of intussusception.
- Diagnostic imaging including abdominal ultrasound.
- Surgical intervention (laparoscopic appendectomy).
Main Results:
- Initial diagnosis of ileocolic intussusception successfully reduced via hydrostatic enema.
- Persistent symptoms led to re-evaluation, revealing acute appendicitis with a fecalith.
- Intraoperative findings confirmed perforated appendicitis.
Conclusions:
- Continuous patient assessment is crucial, even after initial treatment.
- Maintaining a broad differential diagnosis for pediatric abdominal pain is essential.
- Interdisciplinary collaboration improves patient outcomes in complex pediatric surgical cases.
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