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Pediatric Surgery International

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01-08-2019 | Lymphoma | Original Article

Intussusception in children: lessons learned from intestinal lymphoma as a rare lead-point

Authors: H. R. Bussell, S. Kroiss, S. J. Tharakan, M. Meuli, U. Moehrlen

Published in: Pediatric Surgery International | Issue 8/2019

Abstract

Background

Most cases of intussusception in children are idiopathic. Rarely, a malignant disease such as intestinal lymphoma may cause intussusception. Due to dramatic changes of expected outcome with chemotherapy regime alone, the surgical management of patients with intestinal lymphoma presenting with intussusception has to be reevaluated.

Methods

Retrospective chart review from May 2011 to February 2017. We included all patients with intestinal lymphoma presenting with intussusception.

Results

We found five patients with a mean age of 6.4 years (range 3–16). The most common presenting symptom was abdominal pain for several weeks which had acutely worsened. In all but one patient an ultrasound before pneumatic or hydrostatic reduction showed a finding suspicious of a pathological lead-point. Pneumatic or hydrostatic reduction was attempted in all patients, no complications were noted. In one patient reduction was not successful. Recurrence after reduction occurred in two patients. Two patients needed surgery, three had a percutaneous ultrasound-guided biopsy for diagnostic purposes. All patients had aggressive mature B cell non-Hodgkin lymphoma.

Conclusion

A high index of suspicion for the presence of a pathological lead-point in children older than 4 years and children with recurrent intussusception is necessary in patients presenting with intussusception. Malignant, highly aggressive B cell non-Hodgkin lymphoma, although rare, must actively be searched for. Pneumatic or hydrostatic reduction should remain the first line treatment in most cases.

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Title: Intussusception in children: lessons learned from intestinal lymphoma as a rare lead-point
Authors: H. R. Bussell
S. Kroiss
S. J. Tharakan
M. Meuli
U. Moehrlen
Publication date: 01-08-2019
Publisher: Springer Berlin Heidelberg
Keywords: Lymphoma
Ultrasound
Non-Hodgkin Lymphoma
Ultrasound
Published in: Pediatric Surgery International / Issue 8/2019
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-019-04488-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Intussusception in children: lessons learned from intestinal lymphoma as a rare lead-point

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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