[Surgical aspects of intussusception due to lymphoma in children].
BACKGROUND
Intussusception due to lymphoma is a challenging condition for pediatric surgeons. The aim of this study is to report seven cases of this entity and to discuss its management.


METHODS
Six boys and one girl, 3-15-years-old, were admitted for intussusception secondary to a lymphoma. All patients underwent laparotomy: biopsy of massive abdominal tumor 6 and 8 weeks following resection of an intussusception (two cases), ileal resection of non-reductible intussusception (one case), right hemicolectomy for tumor of the appendix (one case), tumorectomy of localized ileal tumor (two cases), enlarged mesenteric lymph node biopsy associated with simple reduction of intussusception (one case). All children were successfully treated with protocol chemotherapy with a 15-month to 13-year follow-up. No relapse was observed.


CONCLUSIONS
Surgeons should be aware of operative sights of ileal lymphomas. Diagnosis of lymphoma may be difficult after manual reduction of intussusception. A sample of any abnormality (mesenteric lymph node, peritoneal fluid) should be taken. Intestinal resection allows to reduce the intensity of chemotherapy but must be as limited as possible: ileal resection in cases of complicated intussusception, tumorectomy "in sano" in cases of ileal parietal isolated tumor. Reduction of intussusception alone (with no resection of ileal tumor) seems to be effective if diagnosis of lymphoma is possible from peripheral samples (peritoneal fluid, pleural effusion, mesenteric lymph node, bone marrow biopsy...).
Piolat
C
C
Service de chirurgie pédiatrique générale, centre hospitalier universitaire de Grenoble, 38043 Grenoble, France. cpiolat@chu-grenoble.fr
Courtot
H
H
Plantaz
D
D
Nugues
F
F
Durand
C
C
Jacquier
C
C
Pasquier
D
D
Dyon
J F
JF
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000150:complications*; D007443:Intussusception / Q000209:etiology* / Q000601:surgery*; D008228:Lymphoma, Non-Hodgkin / Q000150:complications*; D008297:Male