{"title":"阑尾息肉引起的特发性肠套叠:病例报告","authors":"Mazen Kurdi","doi":"10.1016/j.epsc.2024.102859","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Intussusception, primary or secondary, is a common cause of mechanical obstruction in infants and children. Rarely, however, an intussusception is caused by a lesion of the appendix.</p></div><div><h3>Case presentation</h3><p>A thirty-two-month-old female was brought to the emergency department with abdominal pain and passage of red currant jelly stool. The abdominal exam revealed a palpable mass in the upper abdomen. Ultrasound examination of the abdomen showed the classical signs of an ileocolic intussusception: target sign in the transverse view and pseudokidney sign in the longitudinal view. A hydrostatic barium enema reduction was done. Successful reduction of the intussusception was confirmed by seeing the contrast reflux into the ileum. However, several hours later the abdominal pain recurred, and a follow-up ultrasound showed recurrence of the intussusception. The patient was taken to the operating room for an exploratory laparotomy. Following the manual reduction of the intussusception, a palpable mass was identified at the base of the appendix protruding into the cecum. An enterotomy was made on the cecum near the base of the appendix, and a polyp was found protruding from the inside the appendix into the cecum. We did an appendectomy, which included the polyp. The patient recovered uneventfully. The pathology analysis was consistent with a juvenile polyp.</p></div><div><h3>Conclusion</h3><p>Although rare, appendiceal polyps can serve as a lead point for intussusception of the ileocecal region. Such type of intussusception may recur after a reduction enema and may require a surgical exploration.</p></div>","PeriodicalId":45641,"journal":{"name":"Journal of Pediatric Surgery Case Reports","volume":"109 ","pages":"Article 102859"},"PeriodicalIF":0.2000,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213576624000873/pdfft?md5=803e5c823ee84fdbe6e33fb3c05849b2&pid=1-s2.0-S2213576624000873-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Idiopathic intussusception caused by a polyp in the appendix: A case report\",\"authors\":\"Mazen Kurdi\",\"doi\":\"10.1016/j.epsc.2024.102859\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Intussusception, primary or secondary, is a common cause of mechanical obstruction in infants and children. Rarely, however, an intussusception is caused by a lesion of the appendix.</p></div><div><h3>Case presentation</h3><p>A thirty-two-month-old female was brought to the emergency department with abdominal pain and passage of red currant jelly stool. The abdominal exam revealed a palpable mass in the upper abdomen. Ultrasound examination of the abdomen showed the classical signs of an ileocolic intussusception: target sign in the transverse view and pseudokidney sign in the longitudinal view. A hydrostatic barium enema reduction was done. Successful reduction of the intussusception was confirmed by seeing the contrast reflux into the ileum. However, several hours later the abdominal pain recurred, and a follow-up ultrasound showed recurrence of the intussusception. The patient was taken to the operating room for an exploratory laparotomy. Following the manual reduction of the intussusception, a palpable mass was identified at the base of the appendix protruding into the cecum. An enterotomy was made on the cecum near the base of the appendix, and a polyp was found protruding from the inside the appendix into the cecum. We did an appendectomy, which included the polyp. The patient recovered uneventfully. The pathology analysis was consistent with a juvenile polyp.</p></div><div><h3>Conclusion</h3><p>Although rare, appendiceal polyps can serve as a lead point for intussusception of the ileocecal region. Such type of intussusception may recur after a reduction enema and may require a surgical exploration.</p></div>\",\"PeriodicalId\":45641,\"journal\":{\"name\":\"Journal of Pediatric Surgery Case Reports\",\"volume\":\"109 \",\"pages\":\"Article 102859\"},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2024-08-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2213576624000873/pdfft?md5=803e5c823ee84fdbe6e33fb3c05849b2&pid=1-s2.0-S2213576624000873-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pediatric Surgery Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2213576624000873\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatric Surgery Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2213576624000873","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PEDIATRICS","Score":null,"Total":0}
Idiopathic intussusception caused by a polyp in the appendix: A case report
Introduction
Intussusception, primary or secondary, is a common cause of mechanical obstruction in infants and children. Rarely, however, an intussusception is caused by a lesion of the appendix.
Case presentation
A thirty-two-month-old female was brought to the emergency department with abdominal pain and passage of red currant jelly stool. The abdominal exam revealed a palpable mass in the upper abdomen. Ultrasound examination of the abdomen showed the classical signs of an ileocolic intussusception: target sign in the transverse view and pseudokidney sign in the longitudinal view. A hydrostatic barium enema reduction was done. Successful reduction of the intussusception was confirmed by seeing the contrast reflux into the ileum. However, several hours later the abdominal pain recurred, and a follow-up ultrasound showed recurrence of the intussusception. The patient was taken to the operating room for an exploratory laparotomy. Following the manual reduction of the intussusception, a palpable mass was identified at the base of the appendix protruding into the cecum. An enterotomy was made on the cecum near the base of the appendix, and a polyp was found protruding from the inside the appendix into the cecum. We did an appendectomy, which included the polyp. The patient recovered uneventfully. The pathology analysis was consistent with a juvenile polyp.
Conclusion
Although rare, appendiceal polyps can serve as a lead point for intussusception of the ileocecal region. Such type of intussusception may recur after a reduction enema and may require a surgical exploration.