A rare case report of a neonatal idiopathic intussusception
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3300 g, a full-term male was born at 38 weeks of gestation by normal spontaneous vaginal delivery. Pregnancy was uneventful. Prenatal ultrasound, neonatal physical examination at birth, and the first meconium passage were normal. He tolerated oral feeding and had daily defecation.

On the fifth day of life, he began to have bilious vomiting and progressive abdominal distention; Consequently, enteral feeding was discontinued. He was referred to our department at day 7 of life with fecaloid vomiting, distended abdomen and absence of intestinal transit. The newborn was in poor condition, dehydrated, and hypothermic. A nasogastric tube was inserted and fecaloid gastric residuals came out. The baby was intubated immediately due to respiratory distress and was admitted to the neonatal intensive care unit. An abdominal ultrasound was performed. The ultrasound showed small bowel distension and diffuse bowel wall thickening upstream a subhepatic ileocecal intussusception. The latter showed the classic target and pseudo kidney signs extending on 35.5 mm without blood flow within it. There was a diffuse mesenteric fat infiltration without any intra-abdominal fluid nor an abdominal mass.

Complete blood count indicated anemia with thrombocytopenia and mild leukocytosis. Blood biochemistry showed hyponatremia hyperkalemia and renal impairment. After promptly resuscitation, an emergency laparotomy was performed. The access to the abdominal cavity was obtained through a midline upper abdominal incision. Exploration revealed dilated small bowel upstream of a five-centimeter-ileocecal intussusception, that was reduced with retrograde manual pressure. The palpation of focal thickening of the cecal wall required the resection of 3 cm of the terminal ileum and the cecal segment followed by an ileocolic end-to-end anastomosis. The remaining bowel was normal.

The pathologic study confirmed the presence of an intussusception with areas of hemorrhagic rearrangements within the ileal wall. No lead point was detected and there was no proof of concomitant infection. The infant was followed up in the neonatal intensive care unit. The post-operative period was stormy: The child succumbed on the third post-operative hour to septicemia, persistent hypotension and multiple organ dysfunction syndrome. The patient died from septicemia.

Source: https://www.sciencedirect.com/science/article/pii/S2210261220309615?dgcid=rss_sd_all