Iranian Journal of Pediatric Surgery

Abstract

Intrauterine intussusception is a rare cause of intestinal atresia. Intrauterine intussusception was identified as etiological factor in only 0.6% of the cases. The pathophysiology of this correlation remains unclear. Antenatal intussusception leads to a partial intestinal necrosis and intestinal atresia in the concerned digestive segment. Here we report a case of ileal atresia consequent to intrauterine intussusception.
A full-term neonate presented with features of neonatal intestinal obstruction. Antenatal ultrasound was normal. Screening neonatal examination at birth was normal. At presentation, vital signs were normal, abdomen was distended with bilious residue in the nasogastric tube. Abdominal radiography showed dilated small intestine with multiple air-fluid levels. Pre-operative Ultrasound scan showed intussusception with dilated bowel loops. At surgical exploration the neonate had ileal atresia with ileo-ileal intussusception, just distal to the atretic ileal segment. The neonate was managed successfully by resection and end to back anastomosis.
The authors conclude that intrauterine intussusception is one of the rare causes of intestinal atresia and if an antenatal scan shows any target sign without any bowel dilatation, the baby should be delivered at a tertiary care center having neonatal intensive care facility, as it might lead to ischemia and atresia of the involved bowel.