• Clinical and Experimental Pediatrics
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• v.51 no.5
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• pp.500-505
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• 2008

Purpose : We analyzed the clinical features, management and outcome of small bowel intussusception in children compared with ileocolic intussusception. Methods : We retrospectively reviewed the records of 210 children with documented intussusception, in whom intussusception was initially diagnosed by ultrasonography during the four-year period of 2002 to 2005. Results : A total of 191 children were diagnosed with ileocolic intussusception and 19 were diagnosed with small bowel intussusception. Children with small bowel intussusception were older than children with ileocolic intussusception (P<0.05). In comparison to patients with ileocolic intussusception the characteristic presenting symptoms- such as currant jelly stool and palpable mass- were rarely observed in patients with small bowel intussusception. In ileocolic intussusception, air reduction (92.2%), or surgical reduction (7.3%) was performed; however, in small bowel intussusception, spontaneous reduction (78.9%) was observed and no surgical reduction was required in our study. Conclusion : Conservative management with close observation and follow-up sonographic evaluation rather than an immediate operation is recommended for children with small bowel intussusception.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.2
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• pp.134-137
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• 2015

In children presenting to hospital with gastrointestinal symptoms, diseases such as intussusception and acute appendicitis require particular attention and careful examination. Early diagnosis and proper treatment are important because of possible severe complications such as peritonitis and death. Intussusception and appendicitis share similar clinical manifestations. More importantly, the presence of acute appendicitis together with intussusception in children is very rare. We describe an interesting case of a 38-month-old boy who presented with abdominal pain in the right lower quadrant. His vital signs were stable and laboratory test findings showed no specific alterations. We detected tenderness in the right lower quadrant. A computed tomography scan showed an ileocolic intussusception with no strangulation and diffuse wall thickening of the appendix trapped within the intussusception. The patient underwent an appendectomy and manual reduction.

• Advances in pediatric surgery
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• v.6 no.2
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• pp.149-152
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• 2000

Gastroduodenal intussusception, an invagination of a part of the gastric wall through the pyloric canal into the duodenum is a rare condition. Gastroduodenal intussusception is caused by a mobile usually benign gastric tumor. However, gastroduodenal intussusception by gastric submucosal hemangiomatosis is not documented. We have managed a case of gastric submucosal tumor leading to gastroduodenal intussusception in 2 years and 10 months old boy. The tumor was $10{\times}5{\times}3cm$ in size in posterior wall of gastric antrum. Laparotomy, manual reduction of the intussusception, and wedge resection of posterior gastric wall including the tumor were performed. Pathologic diagnosis was a submucosal hemangiomatosis.

• Journal of Yeungnam Medical Science
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• v.33 no.2
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• pp.116-119
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• 2016

Intussusception is a serious disease where part of the intestine slides into an adjacent part of the intestine. Adult intussusception is mainly due to benign or malignant neoplasm. Therefore, in most cases of adult intussusception, treatment by surgery would be preferable to conservative therapy. However, we report on a 28-year-old female patient who underwent intussusception operation delayed 3 months. Abdominal computed tomography 3 months ago showed a small bowel intussusception measuring 20 cm long. Three months later, the previously identified small bowel intussusception appeared without change. The patient underwent surgery, and ectopic gastric mucosa was observed in the biopsy. Therefore, Meckel's diverticulum was diagnosed.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.1
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• pp.70-74
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• 2006

Isolated small bowel intussusception accounts for 10% of all pediatric intussusception. It is more common in children older than 2 years of age. Presentation usually is with vomiting and abdominal pain. Currant jelly stool and palpable mass are less frequent than typical intussusception. There are few reported cases of children with transient small bowel intussusception. We describe 3-year-old boy presented with intermittent cyclic crampy abdominal pain for 6 months was diagnosed as having recurrent transient small bowel intussusception by abdominal ultrasonography and small bowel series.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.4
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• pp.269-272
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• 2013

Association between celiac disease and intussusception has been reported in adult. Although intussusception is common in children, it rarely has been reported in association with celiac disease. Two children, 5 and 7 years old, with celiac disease are reported here, whose initial presentation was intussusception prior to investigation for concomitant failure to thrive. They presented with acute and severe abdominal distention with vomiting, and donuts and pseudo- kidney appearance in abdominal ultrasonography. One patient's intussusception had reducted spontaneously, however the other had required surgery. In investigation for concomitant failure to thrive, tissue transglutaminase levels were very high and duodenal biopsies revealed celiac disease. Thus celiac testing is recommended in children with intussusception and growth failure.

• Advances in pediatric surgery
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• v.19 no.2
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• pp.66-72
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• 2013

Intussusception is common cause of intestinal obstruction in children. Most of intussusceptions can be treated with non-operative reduction using air or barium. However, about 10% patients need operative treatment due to failure of reduction, peritonitis, and recurrence after reduction. We introduce our experience of laparoscopic surgery for intussusception. From April 2010 to March 2013, we reviewed 57 children who diagnosed intussusception. Twelve patients underwent an operation. The cause of operation was 7 of failure of air reduction and 5 of recurrence after air reduction. Median age was 21.5 months (range: 5.0~57.7 months) and 11 children (91.7%) underwent successful laparoscopic reduction. Median operating time was 50 minutes (range: 30~20 minutes) and median hospital days was 4.5 days (range: 3~8 days). One patient had a leading point as a heterotopic pancreas and underwent bowel resection through conversion. There was neither intra-operative nor postoperative complication. Laparoscopic reduction for intussusception can bring an excellent cosmetic effect with high success rate.

• Clinical Endoscopy
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• v.51 no.6
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• pp.591-595
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• 2018

Intussusception after colonoscopy is an unusual complication. A MEDLINE search revealed only 7 reported cases. We present a report of a 28-year-old man who developed abdominal pain several hours after routine colonoscopy and in whom computed tomography (CT) revealed colocolic intussusception. We postulate that this condition is iatrogenic and induced by suctioning of gas on withdrawal of the colonoscope. A common observation among the reported cases was abdominal pain several hours after colonoscopy and right-sided intussusception. All cases had colonoscopy reaching the right side of the colon. Treatment for adult intussusception remains controversial with regard to reduction versus resection, especially given the high association with a pathological cause and malignancy. Among the 8 reported cases, only the current case did not require surgery. A combination of benign colonoscopy, CT, and the clinical picture should provide sufficient information to initially choose a more conservative treatment approach.

• Neonatal Medicine
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• v.28 no.1
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• pp.29-35
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• 2021

Purpose: Intussusception is the most common cause of bowel obstruction in children; however, it is rarely diagnosed in newborn infants. This study aimed to describe the clinical features of intussusception in newborn infants. Methods: Medical records of eight patients diagnosed with intussusception during the newborn period at Ulsan University Hospital between March 2007 and March 2020 were retrospectively reviewed. Results: Among the eight cases, two occurred in the intrauterine period and six occurred in the postnatal period. Intrauterine intussusception presented with symptoms of bowel obstruction within 1 to 2 days after birth, and ileal atresia was diagnosed simultaneously through exploratory laparotomy. All the postnatal patients were extremely low birth weight infants (median gestational age and birth weight: 25⁺⁶ weeks and 745 g, respectively). Four cases were diagnosed preoperatively using abdominal ultrasonography. One patient was diagnosed by exploratory laparotomy because the clinical symptoms were nonspecific and difficult to differentiate from those of necrotizing enterocolitis, a more prevalent complication in preterm infants. The site of intussusception in all six patients was the small bowel. Meckel's diverticulum (one case) and meconium obstruction (two cases) were found to be the lead point. Conclusion: Neonatal intussusception tends to show different clinical features according to its period of occurrence. Intussusception, especially in preterm infants, has nonspecific clinical features; therefore, clinicians should always be cautious of this disease for its early diagnosis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.2
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• pp.135-144
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• 2021

Purpose: Although ultrasonography is the gold standard of diagnosing intussusception, plain abdomen radiograph (AXR) is often used to make differential diagnosis for pediatric patients with abdominal pain. In intussusception patients, we aimed to analyze the AXR and clinical data to determine the characteristics of early AXR findings associated with diagnosis of intussusception and recurrence after reduction. Methods: Between January 2011 and June 2018, 446 patients diagnosed with intussusception based on International Classification of Diseases-10 code of K56.1 were admitted. We retrospectively reviewed medical records of 398 patients who received air reduction; 51 of them have recurred after initial reduction. We evaluated six AXR features including absent ascending colon gas, absent transverse colon gas, target sign, meniscus sign, mass, and ileus. Clinical data and AXR features were compared between single episode and recurrence groups. Results: Two groups did not show significant differences regarding clinical data. Mean time to recurrence from air reduction was 3.4±3.2 days. Absent ascending colon gas (63.9%) was the most common feature in intussusception, followed by mass (29.1%). All of six AXR features were observed more frequently in the recurrence group. Absent transverse colon gas was the most closely associated AXR finding for recurrence (odds ratio, 2.964; 95% confidence interval, 1.327-6.618; p=0.008). Conclusion: In our study, absence of ascending colon gas was the most frequently seen AXR factor in intussusception patients. Extended and careful observation after reduction may be beneficial if such finding on AXR is found in intussusception patients.