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Rippel, Sara W MD*; Olivé, Anthony P MD†; Wesson, David E MD†,‡; Oesterreicher, Sandy H MD†; Wilsey, Michael J Jr, MD*
*Department of Pediatrics, University of South Florida College of Medicine, Tampa, USA
†Departments of Pediatrics, USA
‡Surgery, Baylor College of Medicine, Houston, Texas, USA
The authors report no conflicts of interest.
An 11-year-old girl presented with acute abdominal pain after a 5-month history of intermittent colicky abdominal pain associated with nonbilious vomiting and weight loss. An ileo-ileocolic intussusception was noted on ultrasound, but the barium enema was negative. During diagnostic colonoscopy, a spontaneous ileo-ileocolic intussusception occurred at the level of the hepatic flexure. Endoscopic air insufflation was used to successfully reduce the large mass down to the cecum, through the ileocecal valve, to a level proximal to the ileum. Subsequent Meckel's scan was negative and the patient was discharged home after close observation. Her symptoms recurred and a Meckel's diverticulum was found at laparotomy.
Ileo-ileocolic intussusception due to Meckel's diverticulum is a rare occurrence. In the literature, there are only a handful of case reports, of both children and adults, that describe an intussusception due to Meckel's diverticulum (1). There are more than 1 dozen cases in the adult and pediatric literature in which colonoscopy was instrumental in the diagnosis and/or reduction of colonic intussusception (2). This case highlights the endoscopic findings.
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© 2008 Lippincott Williams & Wilkins, Inc.
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