Postoperative intussusception in children: a keen diagnosis in postoperative ileus.

We investigated the patients who developed postoperative intussusception after a variety of intraabdominal procedures in order to identify the differentiating features and facilitate the prompt recognition and management of this entity. Fourteen patients with postoperative intussusception following an abdominal surgery between 1993 and 2010 were analyzed retrospectively. The primarily applied surgeries were: repair of diaphragmatic hernia (n=3), choledochal cyst excision (n=2), extraction of surrenal neuroblastoma (n=2), Duhamel operation (n=1), colostomy closure (n=1), Nissen fundoplication with (n=1) and without (n=1) gastrostomy, gastropexy (n=1), gastrostomy and jejunostomy (n=1), and manual reduction of ileocolic intussusception (n=1), with a median duration of 135 minutes (120-240). Patients were reoperated on the 3rd day (2-16); intussusception was ileoileal in 11, and was manually reduced in 12 of all patients. Postoperative intussusception differs from other cases of invagination with respect to the pathogenesis, clinical presentation and therapeutic approach. The original operations are mostly the major and lengthy ones, with vicinity to the diaphragm. Awareness of this entity by surgeons and differentiation from other causes of postoperative ileus are obligatory for prompt recognition and management.