Postoperative intussusception following surgical repair of third-grade spleen rupture in a child: A unique case report.

INTRODUCTION AND

IMPORTANCE

Postoperative intussusception (POI) is a remarkably rare complication that may follow different types of operations. POI is responsible for 5-10 % of postoperative bowel obstruction. The main challenge in diagnosing this condition due to its nonspecific symptoms, which mimic post-op ileus.

CASE PRESENTATION: An 8-year-old Syrian female was presented to the emergency department with multiple traumas. Laboratory tests were normal except for leukocytosis. Abdominal and pelvic ultrasound revealed a moderate amount of free fluid in Morison's pouch and splenorenal recess. Investigative laparotomy revealed third-degree splenic rupture, leading to splenorrhaphy. After a week, she suffered from sudden nausea and bilious vomiting. The patient's condition deteriorated, so a second investigative laparotomy was performed and revealed the presence of jejune-jejunal intussusception (1 m distally from the ligament of Treitz) without any predisposing lead point. The intussusception was manually solved, the patient was discharged after five days. She has been seen in follow-up with complete recovery.

CLINICAL DISCUSSION: POI is one of the rare complications that may happen after various surgeries especially abdominal operations. POI is associated with some specific surgeries. The most prominent symptoms of POI are restlessness, bilious vomiting, abdominal distension, and abdominal pain, consequently, they are less specific.

CONCLUSION

POI is a rare complication after surgery but it should be considered in case of the presence of bowel obstruction symptoms in the first two weeks after operation. Our case highlights this unexpected complication emphasizes the need for further studies to demonstrate the mechanism of postoperative intussusception.