Abstract
A 10-month-old boy was referred to our hospital with bloody stool. Abdominal ultrasonography demonstrated intussusception of the descending colon with a target sign, and abdominal computed tomography revealed a slightly enhanced mass in the same region. Barium enema study showed a pedunculated polyp, approximately 15 mm in size, forming the leading edge of the intussusception. Endoscopic resection of the polyp was performed during colonoscopy under general anesthesia and the resected specimen was histopathologically diagnosed as juvenile polyp. No recurrence of intussusception has been observed to date.
A relatively frequent cause of pediatric intestinal obstruction, intussusception is usually ileocolic with no underlying organic disease. Colocolic intussusception is very rare, and most cases are associated with underlying bowel lesions such as juvenile and Peutz-Jeghers polyps. When a pediatric patient presents with bloody stool or abdominal pain suggestive of colocolic intussusception, colonoscopy is recommended. This should be performed under appropriate sedation with the endoscope selected in consideration of the patient's age and physical attributes. Endoscopic polypectomy is believed to be more useful than surgical treatment when organic lesions such as juvenile polyps are present, as in the present case.
