A Case of Neonatal Ileal Perforation With Both Intussusception and Ileal Atresia

Abstract

A 1-day-old female neonate presented with persistent vomiting 10 hours after birth. Prenatal assessments were not particular. She was born weighing 3,670 g at 38 weeks and 2 days of gestation. Her Apgar score was 8/7. An abdominal X-ray revealed free air, which indicated gastrointestinal perforation. An emergency laparotomy was performed, which identified an ileal perforation 15 cm from the ileocecal valve. Additionally, intussusception was observed distal to the perforation. A 10 cm segment of the dilated and intussuscepted bowel was resected, and an end-to-end anastomosis was performed. Pathological examination of the resected specimen revealed an intussuscepted ileum with the intussusception completely closed. The final diagnosis was ileal perforation caused by ileal atresia that coexisted with intussusception. Neonatal intussusception is rare, and these findings suggest that the ileal atresia was due to compromised blood flow caused by intussusception. The co-occurrence of ileal atresia and intussusception is extremely rare, and the pathogenesis of the ileal atresia in this patient is reported in this paper.