Neonatal Ileo-Ileal and Ileo-Cloacal Exstrophic Synchronous Dual Intussusceptions in a Preterm Infant With Cloacal Exstrophy

We report an ex-35 weeks gestational age preterm female infant with prenatally diagnosed cloacal exstrophy who developed ileo-ileal and ileo-exstrophic dual synchronous intussusceptions at the corrected age of 3 weeks. The infant presented with acute illness. Initial fluid resuscitation and antibiotic treatment improved clinical condition but developed bleeding and increasingly discolouration of the distal loop associated with metabolic acidosis and concern for bowel obstruction and ischemia. Radiographs were non-specific. At exploration an irreducible necrotic advanced ileo-ileal intussusception and a reducible but viable ileo-exstrophic intussusception were found. Resection of necrotic ileo-ileal intussusception with ileostomy formation on the proximal end and closure of the distal ileum with reduction of ileo-exstrophic intussusception was carried out uneventfully with good prognosis. World J Nephrol Urol. 2016;5(1):20-22 doi: http://dx.doi.org/10.14740/wjnu253w