Title:
Intestinal lymphoma as leading point in intussusception in older children
Authors / Address of institution:
H. R. Bussell, U. Subotic, N. Zweifel, S. J. Tharakan, M. Meuli, U. Moehrlen
Universitäts Kinderspital Zürich, Chirurgische Klinik, Steinwiesstrasse 75, 8032 Zürich
Background / Introduction:
Intussusception is a common pediatric surgical entity encountered in infants and young children which
is mostly idiopathic. In older children, however, it is rare and a pathological lead point needs to be
excluded. We present a case series of 4 patients presenting with intussusception due to intestinal
lymphoma.
Methods:
We performed a retrospective chart review of our patients presenting with intussusception due to an
intestinal lymphoma from February 2012 to February 2017.
Results:
Between February 2012 and February 2017 we treated four patients with an intussusception due to
intestinal lymphoma. Thereof two patients were girls and two were boys, their median age was 9.5
years (range 6 - 16). Two patients could be treated with pneumatic / hydrostatic reduction and
chemotherapy alone, whereas in two other patients laparotomy with manual desinvagination and ileal
segment resection was necessary followed by chemotherapy. So far all patients are remission-free
(median follow up 2.5 years, range 0 - 5 years).
Conclusion:
In older children with intussusception a pathological lead point has to be sought. Malignant disease
must actively be excluded and may be difficult to diagnose. Pneumatic or hydrostatic reduction should
be the first treatment option. Additional imaging (MRI/CT scan) is recommended to rule out/diagnose
lymphomas. If surgery is necessary, mutilating surgery should be avoided due to good prognosis of
intestinal lymphoma after appropriate chemotherapy.
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