Laparoscopic Reduction of Ileo-Ileal Intussusception in an Infant Operated for Wilms Tumor
نویسندگان
چکیده
A 55-day-old male baby underwent an exploratory laparotomy and a radical left nephro-ureterectomy with peri-hilar and para-aortic lymph nodal dissection for a left sided Wilms’ tumor. Postoperative course was smooth until 4thpostoperative day when mild abdominal distension and bilious nasogastric (NG) tube drainage of 95 ml was noticed. An x-ray abdomen was inconclusive while ultrasound (US) abdomen revealed a bowel mass with a target sign at the right pelvic region suggestive of intussusception. A trial of water-soluble contrast enema reduction was given which showed hold up of contrast at the ileum, followed by free passage of contrast into the normal caliber ileum. The intussusception mass was not visualized at subsequent US. The patient’s clinical condition did not improve with NG tube draining 160 ml bilious aspirate following 24 hours and a repeat US showed recurrence of intussusception. It was then decided for laparoscopic exploration. An ileoileal intussusception was found which was easily reduced laparoscopically and bowel appeared viable (Fig.1). The postoperative course was uneventful then. The histopathology reported COG Stage I Wilms’ tumor (triphasic) with favorable histology.
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Laparoscopic-assisted resection of ileal lipoma causing ileo-ileo-colic intussusception.
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