Neglected Intussusception Presenting as Transanal Prolapse of Small Bowel

Abstract

Although transanal prolapse of intussusception in infants is well recognized, it is rarely reported and confusion with rectal prolapse often results in delayed diagnosis and treatment. This report highlights the problems of delayed diagnosis and the morbidity and mortality associated with this condition. The authors report a case of 9 mo old boy who presented with prolapsing small bowel mimicking rectal prolapse.

Transanal protrusion of intussusceptions in children

“…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.…”

Neglected Intussusception Presenting as Transanal Prolapse of Small Bowel

“…In case of transanal prolapse of intussusception, it can be easily diagnosed by a digital rectal examination as mentioned in the article. [1] If you fail to diagnose intussusception early then the morbidity and mortality is increased considerably.…”

Transanal protrusion of intussusceptions

“…Ameh and Mshelbwala noted "the risk of morbidity and mortality in anal protruding intussusception is high" [2] and also mentioned for necessity of early detection and management. [3] The use of radiological approach might be useful for helping differential diagnosis. [3] The use of radiological approach might be useful for helping differential diagnosis.…”

“…[1] As report by Marte et al, "the safety integrity level (SIL-V) procedure is safe and effective and allows fast and efficient isolation of the vascular bundle." [2,3] In addition, the postoperative undersigned outcomes can be seen in some cases. However, there are some concerns on SIL-V procedure.…”

“…[1] In fact, SIL-V procedure might be a good alternative. [3] Sherif et al concluded that "using specially designed ports and instruments in selected patients" [3] were required for success of the procedure. First, it should be noted that the case selection must be well-done.…”