Anal protrusion of intussusception

Coghill, Joanna; Mensah,

doi:10.1136/bcr.09.2009.2314

Cited by 4 publications

(5 citation statements)

References 2 publications

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“…[2,5] Likewise, most case reports of TAPIs occurred in female children [4] and adults. [1,10] These statistics are in contrast to childhood intussusceptions in general where males are usually more affected than females.…”

Section: Discussionmentioning

confidence: 99%

“…Transanal protrusion of intussusceptions (TAPIs) is a unique complication of intusssusception in children and usually occurs when the normally retroperitoneal ascending and descending colons are freely mobile being completely peritonealised with long mesenteries. [1,2] TAPI is an uncommon presentation of childhood intussusceptions and most publications on this topic are case reports [1,3,4] and case series [2,[5][6][7] from low and middle income countries of Africa and Asia.…”

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confidence: 99%

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Transanal protrusion of intussusceptions in children

Obiora

Ekenze

Ogundu

2014

Afr J Paediatr Surg

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Transanal protrusion of intussusceptions in children

Obiora

Ekenze

Ogundu

2014

Afr J Paediatr Surg

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“…A high index of suspicion and history is suggestive, in patients presenting with rectal bleeding. 1,2 During clinical examination a sulcus is felt between the rectal wall and the protruding mass. 3 Hence, a thorough clinical examination to differentiate a Trans anal Protrusion of Intussusception (TAPI) from a rectal prolapse is essential.…”

Section: Discussionmentioning

confidence: 99%

Trans-anal protrusion of intussusception (TAPI) revisited: managed successfully in a resource limited hospital setting

Basu

2018

Int Surg J

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Intussusception is the most common cause of Acute bowel obstruction in infants and toddlers. However, a Trans-anal protrusion of an intussusception (TAPI) is relatively rare and is not well reported in literature. A high index of suspicion is essential as the diagnosis is purely clinical, and often confused with rectal prolapse. Most patients present late due to neglect on the part of the parents or the primary treating physician. A late presentation usually results in a poor outcome and increased morbidity and mortality. Uncommonly these children may present early, where a prompt surgical management is desirable. The author reports a single case of a Trans anal protrusion of intussusception (TAPI) in a 1-½ -year old female child who was successfully managed in the author's resource-limited teaching institution without a dedicated pediatric surgery unit.

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“…Transanal protrusion of intussusception is defined as the invagination of an intestinal segment into the segment adjacent to it, with exteriorization of the head of the intussusceptum through the anus [ 5 ]. Most case reports on TAPI occurred in females [ 6 , 9 ], which is contrary to intussusceptions with no transanal protrusions which have a male predominance [ 10 , 11 ]. The average age of occurrence is 5 to 12 months [ 6 , 8 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of intussusception is challenging due to its varied unspecific clinical presentation, ranging from a painless intussusception to constipation, dehydration from diarrhoea and vomiting, intestinal prolapse, rectal bleeding, sepsis, shock, syncope, and altered mental status [ 2 , 9 ]. The classic triad of severe intermittent abdominal pain, red currant jelly stools and vomiting occurs in less than 20% of cases [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Delayed diagnosis of transanal prolapse of an ileo-colic intussusception in a 10-month-old infant in rural Cameroon: a case report

Tianyi¹,

Kadia²,

Dimala

et al. 2017

BMC Res Notes

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BackgroundTransanal 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 presentationA 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.ConclusionsTransanal 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.

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Anal protrusion of intussusception

Cited by 4 publications

References 2 publications

Transanal protrusion of intussusceptions in children

Transanal protrusion of intussusceptions in children

Trans-anal protrusion of intussusception (TAPI) revisited: managed successfully in a resource limited hospital setting

Delayed diagnosis of transanal prolapse of an ileo-colic intussusception in a 10-month-old infant in rural Cameroon: a case report

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