Oral Lactulose-Induced Intussusception: A Rare Complication of Juvenile Colonic Polyp

As an osmotic laxative, lactulose offers superior palatability and comparable bowel-cleansing efficacy to PEG, making it suitable for resource-limited settings, but its hypertonicity may potentially increase the risk of intussusception in susceptible individuals (such as children with intestinal polyps).

This first reported case describes a 2-year-old boy with intermittent hematochezia who developed acute descending colonic intussusception confirmed by CT within hours of receiving lactulose (20 mL) for bowel preparation. Laparoscopic reduction and subsequent colonoscopy identified a large pedunculated juvenile polyp (25 × 28 mm) as the pathological lead point, which was endoscopically resected. The temporal link between lactulose administration and symptom onset, combined with its known pharmacological effects, strongly suggests lactulose-induced hyperperistalsis precipitated intussusception by mechanically displacing the occult polyp.

This highlights a novel risk of osmotic laxatives in children with undiagnosed intestinal polyp.