Delayed diagnosis of transanal prolapse of an ileo-colic intussusception in a 10-month-old infant in rural Cameroon: a case report
- PMID: 29084587
- PMCID: PMC5663146
- DOI: 10.1186/s13104-017-2838-8
Delayed diagnosis of transanal prolapse of an ileo-colic intussusception in a 10-month-old infant in rural Cameroon: a case report
Abstract
Background: Transanal protrusion of intussusception is a complication of intussusception which involves the exteriorization of the apex of the intussusceptum through the anus. However, it is rarely reported and its confusion with rectal prolapse often leads to a diagnostic delay.
Case presentation: A 10-month-old female with no significant past history from a rural area in the Extreme North region of Cameroon was referred from a local health centre to our emergency deparment for an irreducible mass. It was reported that the child had spent 5 days at home on over-the-counter medication, then 3 days at a health centre where she was being treated for a respiratory tract infection and a rectal prolapse. On arrival at our hospital, she was conscious and moderately dehydrated. Cardiopulmonary examination revealed generalized coarse crackles over both lung fields. Her abdomen was tender, with a left upper quadrant mass, absent bowel sounds and a dark anal mass. In view of these, diagnoses of bronchopneumonia, intestinal obstruction and a probable rectal prolapse were made. An exploratory laparotomy was carried out after resuscitation with per-operative findings of a prolapsed ileo- colic intussusception and a necrosed intussusceptum. The necrosed portion was resected and an end-to-end ileo-transverse anastomosis was carried out. The immediate post- operative period was uneventful, but the patient died 3 days after the surgery, from an overwhelming sepsis.
Conclusions: Transanal protrusion of intussusception requires timely surgical intervention to prevent mortality. The similarity in presentation to rectal prolapse coupled with inadequate knowledge on the condition by primary healthcare personnel causes a delay in the diagnosis and an increased mortality. A high index of suspicion is essential for an early diagnosis and an improved referral system for timely and definitive treatment.
Keywords: Case report; Intussusception; Rectal prolapse; Transanal protrusion.
Figures
Similar articles
-
Small bowel transanal evisceration mimicking a rectal prolapse. A case report and review of literature.Ann Ital Chir. 2017 Nov 20;6:S2239253X17027839. Ann Ital Chir. 2017. PMID: 29372693 Review.
-
Transanal protrusion of intussusceptions in children.Afr J Paediatr Surg. 2014 Jul-Sep;11(3):229-32. doi: 10.4103/0189-6725.137331. Afr J Paediatr Surg. 2014. PMID: 25047314
-
Precipitous intussusception with anal protrusion and complete overt rectal prolapse presenting with intestinal obstruction and an associated rectal adenoma in a young man: a case report.BMC Res Notes. 2013 Oct 5;6:401. doi: 10.1186/1756-0500-6-401. BMC Res Notes. 2013. PMID: 24093478 Free PMC article.
-
Anal protrusion of an ileo-colic intussusception in an adult with persistent ascending and descending mesocolons: a case report.BMC Res Notes. 2013 Feb 2;6:42. doi: 10.1186/1756-0500-6-42. BMC Res Notes. 2013. PMID: 23375100 Free PMC article.
-
Transanal protrusion of intussusception in infants is associated with high morbidity and mortality.Ann Trop Paediatr. 2008 Dec;28(4):287-92. doi: 10.1179/146532808X375459. Ann Trop Paediatr. 2008. PMID: 19021945 Review.
Cited by
-
Rectal prolapse associated with intussusception and malignancy.J Surg Case Rep. 2023 Jun 15;2023(6):rjad363. doi: 10.1093/jscr/rjad363. eCollection 2023 Jun. J Surg Case Rep. 2023. PMID: 37332665 Free PMC article.
-
Delays in presentation of intussusception and development of gangrene in Zimbabwe.Pan Afr Med J. 2021 Jul 28;39(Suppl 1):3. doi: 10.11604/pamj.supp.2021.39.1.21301. eCollection 2021. Pan Afr Med J. 2021. PMID: 34548895 Free PMC article.
References
-
- Ibrahim IA. Prolapsed ileocolic intussusception. Ann Pediatric Surg. 2011;7(2):76–78. doi: 10.1097/01.XPS.0000396409.62385.a7. - DOI
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Miscellaneous