The Turkish Journal of Pediatrics
2012 , Vol 54 , Num 4
Postoperative intussusception in children: a keen diagnosis in postoperative ileus
Department of Pediatric Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey. E-mail: suleyal@hacettepe.edu.tr
We investigated the patients who developed postoperative intussusception after
a variety of intraabdominal procedures in order to identify the differentiating
features and facilitate the prompt recognition and management of this entity.
Fourteen patients with postoperative intussusception following an abdominal
surgery between 1993 and 2010 were analyzed retrospectively. The primarily
applied surgeries were: repair of diaphragmatic hernia (n=3), choledochal
cyst excision (n=2), extraction of surrenal neuroblastoma (n=2), Duhamel
operation (n=1), colostomy closure (n=1), Nissen fundoplication with
(n=1) and without (n=1) gastrostomy, gastropexy (n=1), gastrostomy and
jejunostomy (n=1), and manual reduction of ileocolic intussusception (n=1),
with a median duration of 135 minutes (120-240). Patients were reoperated
on the 3rd day (2-16); intussusception was ileoileal in 11, and was manually
reduced in 12 of all patients. Postoperative intussusception differs from other
cases of invagination with respect to the pathogenesis, clinical presentation
and therapeutic approach. The original operations are mostly the major and
lengthy ones, with vicinity to the diaphragm. Awareness of this entity by
surgeons and differentiation from other causes of postoperative ileus are
obligatory for prompt recognition and management.
Keywords :
postoperative obstruction, intussusception, diagnosis, child.