Neonatal Rectal Bleeding Due to Early-Onset Ileocecal Intussusception: A Case Report

Intussusception is a well-recognized cause of intestinal obstruction in infants but is rare in neonates, particularly in preterm infants. Because its clinical presentation can resemble necrotizing enterocolitis (NEC), diagnosis may be delayed when imaging findings are nonspecific. Early recognition is important to prevent complications.

A preterm infant born at 31 + 1 weeks of gestation was discharged on Day 22 after an initial course complicated by respiratory distress, sepsis, jaundice, and Grade I intraventricular hemorrhage (using Papile classification). On the 26^th day, the infant presented with mild abdominal distension and a single episode of rectal bleeding, while vital signs and laboratory findings remained stable. Nevertheless, abdominal radiography was inconclusive. However, due to recurrent rectal bleeding, abdominal ultrasonography was performed and revealed an ileocecal intussusception with preserved vascularity. The infant was managed conservatively, and serial ultrasounds demonstrated spontaneous reduction with complete resolution of symptoms.

Intussusception in preterm neonates may present with subtle clinical signs and can mimic NEC. When abdominal radiographs are inconclusive, ultrasonography plays a crucial role in establishing an early diagnosis and may allow successful conservative management, avoiding unnecessary surgical intervention.