A special type of postoperative intussusception: ileoileal intussusception after surgical reduction of ileocolic intussusception in infants and children.

BACKGROUND: Postoperative ileoileal intussusception after surgical reduction of ileocolic intussusception in infants and children is extremely rare, and no reports of this special type of postoperative small bowel intussusception have been found in the literature.

METHODS: We retrospectively reviewed the clinical charts of 6 infants and children with postoperative ileoileal intussusception that occurred after surgical reduction of ileocolic intussusception between January 1994 and December 2006. Clinical features, diagnostic strategy, operative findings, and outcome were analyzed.

RESULTS: All 6 cases of postoperative ileoileal intussusception after surgery for ileocolic intussusception occurred within 1 week after the initial operation. The clinical manifestation was intestinal obstruction without abdominal palpable mass or bloody stool. Abdominal ultrasound examination revealed the target sign in 5 cases. Manual reduction of the intussusception was performed successfully at reoperation in each instance.

CONCLUSIONS: The clinical symptoms of postoperative ileoileal intussusception after operations for ileocolic intussusception are not typical. A second postoperative (ileoileal) intussusception should be kept in mind after surgical reduction of the first (ileocolic) intussusception in children. In any atypical postoperative ileus, a sonographic study should be done to rule out the diagnosis of postoperative intussusception. Once this condition is diagnosed, surgical treatment should be performed as soon as possible.