Recurrent intussusceptions in an infant that were terminated by laparoscopic ileocolonic pexie.
For children with ileocolic intussusceptions, laparoscopy has been proposed as an emergency intervention, but it has not been elaborated for elective prevention of recurrencies. We report about an infant who developed his first ileocolic intussusception at the age of 12 months. Radiologic devagination was successful, but had to be repeated for two consecutive recurrences within several days. Six months later, he presented with another episode of intussusception, which again was managed conservatively. At this time, preventive surgery seemed indicated. Diagnostic laparoscopy using three trocars and 5-mm instruments showed an insufficient closure of the ileocecal valve, allowing the surgeon easily to provoke an intussusception. Consequently, the distal ileum was attached to the ascending colon with several interrupted 3-0 sutures. The infants postoperative course was uneventful. Oral feeding was started immediately, and he could be discharged after 3 days. Within a follow-up period of 1 year, no evidence of intussusception was noted. We conclude that for children with recurrent episodes of intussusception, laparoscopic ileocolonic pexie presents a beneficial strategy for protective surgery.
Boehm
R
R
Department of Pediatric Surgery, University of Munich, Lindwurmstrasse 4, D-80337 Munich, Germany. roland.boehm@kk-i.med.uni-muenchen.de
Till
H
H
D006801:Humans; D007077:Ileal Diseases / Q000601:surgery*; D007223:Infant; D007443:Intussusception / Q000601:surgery*; D010535:Laparoscopy; D012008:Recurrence