Summary
Transanal protrusion of intussusception (TAPI; also known as prolapsed intussusception) is a rare complication. Here, we present a successful colonoscopic reduction of ileocolic intussusception presented with transanal prolapse. An 8‑month male child, weighing 8 kg, was referred to our hospital presenting with a mass in his anal canal, diarrhea and rectal bleeding for two days. The sonographic evaluation revealed an ileocolic intussusception in the rectosigmoid area. The patient was treated using colonoscopic reduction. To our knowledge, this is the first study reporting colonoscopic reduction for transanal prolapsed intussusceptions. Our study suggests gastroenterologists to consider colonoscopy as a therapeutic method for prolapsed intussusceptions and encourages them to attempt reducing the invagination using this method before laparotomy, especially in cases presenting within 48 h of onset of symptoms and no peritonitis symptoms.
Zusammenfassung
Die transanale Protrusion einer Invagination (TAPI) ist eine seltene Komplikation, die auch als prolabierte Invagination bezeichnet wird. Im Beitrag wird die erfolgreiche koloskopische Reposition einer ileokolischen Invagination mit transanalem Prolaps beschrieben. Ein 8 Monate altes, 8 kg schweres männliches Kind wurde mit einer Raumforderung im Analkanal, Diarrhö und seit 2 Tagen bestehenden rektalen Blutungen in unser Krankenhaus eingewiesen. In der Ultraschalluntersuchung zeigte sich eine ileokolische Invagination im Bereich des Rektosigmoids. Der Patient wurde koloskopisch behandelt. Unseres Wissens ist dies die erste Arbeit, die über eine koloskopische Reposition einer transanal prolabierten Invagination berichtet. Unsere Arbeit schlägt Gastroenterologen vor, die Koloskopie als therapeutisches Verfahren bei prolabierten Invaginationen in Betracht zu ziehen, und ermutigt zu einem koloskopischen Repositionsversuch vor einer Laparotomie, vor allem bei Patienten, die innerhalb von 48 h nach Symptombeginn vorgestellt werden und die keine Peritonitissymptomatik erkennen lassen.
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References
Simon NM, Joseph J, Philip RR, et al. Intussusception: single center experience of 10 years. Indian Pediatr. 2019;56(1):29–32.
Coran Arnold G. Pediatric surgery. 7th ed. : Elsevier Saunders; 2012.
Mathur P, Sultania S, Boipai M, et al. Trans-anal protrusion of intussusception in a neonate. J Pediatr Surg Case Rep. 2020;54:101393.
Ramachandran P, Vincent P, Prabhu S, et al. Rectal prolapse of intussusception—a single institution’s experience. Eur J Pediatr Surg. 2006;16(6):420–2.
Obiora EU, Sebastian EO, Ogundu II. Transanal protrusion of intussucseptions in children. Afr J Paediatr Surg. 2014;11(3):229–322.
Ameh EA, Mshelbwala PM. Transanal protrusion of intussusception in infants is associated with high morbidity and mortality. Ann Trop Paediatr. 2008;28(4):287–92.
Kelley-Quon LI, Arthur LG, Williams RF, et al. Management of intussusception in children: a systematic review. J Pediatr Surg. 2021;56(3):587–96. https://doi.org/10.1016/j.jpedsurg.2020.09.055.
Ibrahim IA. Prolapsed ileocolic intussusception. Ann Pediatr Surg. 2011;7(2):76–8.
Shahramian I, Behi B, Salahifar M, et al. Colonoscopy-assisted resolving of intussusception in children, a report of 15 cases. Ann Colorectal Res. 2020;8(1):1–4.
Frank LT, Benjamin MK, Christian AD, et al. Delayed diagnosis of transanal prolapse of an ileo-colic intussusception in a 10 month old infant in rural Cameroon:a case report. BMC Res Notes. 2017;10:521.
Coghill J, Mensah. Anal protrusion of intussusception. BMJ Case Rep. 2009;2009:bcr920092314.
Ngom G, Kane A, Ndour O, et al. Prolapsed intussusception in children: clinical study and therapeutic aspects. J Pediatr Surg Specialities. 2013;7(1):644.
Jain S, Haydel MJ. Child intussusception. : StatPearls; 2020.
Kolar M, Pilkington M, Winthrop A, et al. Diagnosis and treatment of childhood intussusception from 1997 to 2016: a population-based study. J Pediatr Surg. 2020;55(8):1562–9.
Tafner E, Tafner P, Mittledorf C, et al. Potential of colonoscopy as a treatment for intussusception in children. Endosc Int Open. 2017;5(11):E1116.
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Iraj Shahramian: study concept and design, performing endoscopic examination, study supervision. Fateme Parooie: acquisition of data, writing and drafting of the manuscript. Seyed Ali Mirabbasi: providing radiographic images as well as interpreting the sonographic data. Morteza Salarzaei: contribution in writing and drafting of the manuscript. All authors have read and approved the final version the manuscript.
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I. Shahramian, F. Parooie, S.A. Mirabbasi and M. Salarzaei declare that they have no competing interests.
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Shahramian, I., Parooie, F., Mirabbasi, S.A. et al. Colonoscopic reduction of a transanal prolapsed ileocolic intussusception. Wien Med Wochenschr 172, 322–326 (2022). https://doi.org/10.1007/s10354-022-00915-4
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DOI: https://doi.org/10.1007/s10354-022-00915-4