A rare case report of a neonatal idiopathic intussusception in a full-term newborn

• Published in: International journal of surgery case reports Vol. 77; pp. 1 - 4
• Main Authors: Oumaya, Meriem, Ben Ahmed, Yosra, Souid, Asma, Marzouki, Mariem, Douira, Wiem, Lahmar, Lilia, Jlidi, Said
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-01-2020; Elsevier
• Subjects: Case Report; Early diagnosis; Full-term; Idiopathic; Intussusception; Neonates; Neonates; Case report; Early diagnosis; Intussusception; Full-term; Idiopathic
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2020.10.083

•In contrast with the usual idiopathic intussusception appearing in infants, neonatal intussusception in full-term newborns is a very rare entity.•It’s a challenging diagnosis since it has a misleading and variable presentation.•Early diagnosis may be enhanced with abdominal ultrasonography that showed the classic target and pseudo kidney signs.•An emergency laparotomy must be performed to confirm the ultrasound findings and to reduce the intussusception: Only way to save the patient.•The overall prognosis for neonates with intussusceptions depends on early diagnosis, because once a critical condition develops, as in this case, the mortality rate is likely to rise.
In contrast with the usual idiopathic intussusception appearing in infants, neonatal intussusception in full-term newborns is a rare entity and usually due to an organic lead point lesion. It has a misleading and variable presentation. This manuscript reports a very rare case of neonatal idiopathic intussusception in a full-term male newborn in order to highlight the difficulties in establishing an early diagnosis.
We present a full-term male newborn who was referred to our department at day 7 of life with fecaloid vomiting, distended abdomen and absence of intestinal transit. No bloody stool was identified. The newborn was in poor condition, dehydrated and hypothermic. He was promptly resuscitated and an abdominal ultrasound was quickly performed, it showed an ileocecal intussusception located in the right hypochondriac region. An emergency laparotomy was performed confirming the ultrasound findings. The pathological exam of the resected bowel confirmed the presence of an intussusception with areas of hemorrhagic rearrangements but no lead point was detected. The patient died from septicemia.
Intussusception occurring in the neonate is still difficult to assess, because of its rarity and its uncommon mode of presentation. This case report underlines the importance to make early diagnosis, because once a critical condition develops, the mortality rate is likely to rise.