2020 Volume 16 Issue 3 Pages 155-159
The majority of childhood intussusceptions have idiopathic causes, but 2.7% are due to an underlying disease, of which 5.5% can be attributed to malignant lymphoma. Age is an important factor in the onset of pathologically-related intussusceptions. We report a case in a 15-year-old boy who visited a prior hospital with a chief complaint of sudden-onset severe abdominal pain. Computed tomography revealed intussusception, and the patient was transferred to our hospital within several hours, where high-pressure enema reduction was performed. The ileocecum blockage could not be removed even after multiple high-pressure enemas, so emergency surgery was planned. Intraoperatively, dilation was observed at the terminal ileum, and a hard-mass tumor was palpated in the ileocecum. The ileocecal region containing the mass was excised. A diagnosis of diffuse large B-cell lymphoma was made on the basis of pathological examination, and chemotherapy was initiated. The patient has remained in remission for 2 years and is in good condition. The probability of an underlying diseases increases with age. Adolescent intussusception is often discovered due to the onset of acute abdomen and requires emergency surgery even in the absence of a prior diagnosis. The development of intussusception might be the first sign of malignant disease. In older children who have underlying diseases, as in this case, it is difficult to perform high-pressure enema reductions, even shortly after onset. In cases of intussusception in older pediatric patients, it is necessary to consider the possibility of an underlying disease and carry out early investigations accordingly.
