title: Chronic ileocolic intussusception due to transmural infiltration of diffuse large B cell lymphoma in a 14-year-old boy: a case report.
abstract: Chronic intussusception, defined as intussusception continuing over 14 days, is rare in children. We herein report a case of chronic ileocolic intussusception caused by the transmural infiltration of diffuse large B cell lymphoma in a 14-year-old boy. The patient had been suffering from anorexia and intermittent abdominal pain for 5 weeks, during which his body weight decreased by around 7 kg. Upon admission to our hospital, ultrasonography and enhanced computed tomography (CT) of the abdomen showed ileocolic intussusception. A retrospective examination of abdominal CT led us to suspect that the intussusception had initially appeared 5 weeks before admission, presumably coinciding with the beginning of the patient's abdominal symptoms. Since hydrostatic reduction was unsuccessful, laparotomy was performed, which showed unreducible ileocolic intussusception with a marked edematous ileum and mesentery. Ileocecal resection without lymph node dissection was carried out, and a histological examination of the resected specimen revealed the transmural infiltration of diffuse large B-cell lymphoma of the terminal ileum. The patient's postoperative course was uneventful, and adjuvant chemotherapy was administered. This case illustrates the diagnostic challenges of confirming 'chronic' intussusception in older children.
authors.affiliation: Department of Pediatric Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 6638501 Japan.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Saka
authors.affiliation: Department of Pediatric Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 6638501 Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sasaki
authors.affiliation: Department of Surgical Pathology, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Matsuda
authors.affiliation: Department of Pediatric Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 6638501 Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Nose
authors.affiliation: Department of Pediatrics, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Onishi
authors.affiliation: Department of Pediatrics, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Tetsurou
authors.initials: T
authors.lastname: Fujino
authors.affiliation: Department of Pediatrics, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Shimomura
authors.affiliation: Department of Pediatrics, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Yoshitoshi
authors.initials: Y
authors.lastname: Otsuka
authors.affiliation: Department of Surgical Pathology, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Kajimoto
authors.affiliation: Department of Surgical Pathology, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Hirota
authors.affiliation: Department of Pediatric Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 6638501 Japan.
authors.forename: Takaharu
authors.initials: T
authors.lastname: Oue
keywords: Chronic intussusception; Lymphoma