Intestinal intussusception in the context of acute appendicitis A case report and review of the literature

Abstract

Introduction: Intussusception is an idiopathic abdominal pathology secondary to intestinal processes that act as starting points for intussusception. Cases of dragging of structures that lead to other inflammatory processes, such as acute appendicitis, have been described.

Clinical case: A 3-year-old boy with abdominal pain of 6 hours of evolution. On physical examination, he appeared pale, drowsy, tachycardic, and dehydrated. The abdomen had positive appendiceal signs, with palpation of a mass in the right iliac fossa.

Diagnostic workshop: leukocytes 9690 u/mm3, neutrophils 58.1%. Ultrasound with an image suggestive of intestinal intussusception with inflammatory changes in the mesenteric fat. An abdominal tomography was performed that reported ileocolonic intussusception of 47 x 50 mm, with multiple mesenteric reactive nodes, an appendicular image in the pelvic direction, and an appendicolith inside.

Evolution: Surgical management included an exploratory laparotomy with manual evagination and conventional appendectomy. The pathology report was acute suppurative appendicitis. The patient was hospitalized for 48 hours and received ampicillin + sulbactam and analgesia. When abdominal function improved, he was discharged.

Conclusions: In this case, acute appendicitis was the cause of intestinal intussusception with the ultrasound sign of the "target" in a 3-year-old patient.