Postoperative intestinal intussusception in children

Two cases of postoperative intussusception (POI) are reported. Both children, 13 and 6 months old, had long and difficult surgery for abdominal neuroblastoma after four courses of chemotherapy. Obstruction of the small intestine occurred on the fifth postoperative day, after feeding had been started...

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Published inAnnales françaises d'anesthésie et de réanimation Vol. 11; no. 5; p. 584
Main Authors Velin, P, Dupont, D, Parizot, P, Puig, C, Grinda, A
Format Journal Article
LanguageFrench
Published France 1992
Subjects
Abdominal Neoplasms - surgery
Female
Gastrointestinal Motility - drug effects
Humans
Ileal Diseases - diagnostic imaging
Ileal Diseases - etiology
Infant
Intussusception - diagnostic imaging
Intussusception - etiology
Male
Narcotics - pharmacology
Narcotics - therapeutic use
Neuroblastoma - surgery
Pain, Postoperative - drug therapy
Postoperative Complications
Ultrasonography
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Summary:Two cases of postoperative intussusception (POI) are reported. Both children, 13 and 6 months old, had long and difficult surgery for abdominal neuroblastoma after four courses of chemotherapy. Obstruction of the small intestine occurred on the fifth postoperative day, after feeding had been started again, in the first child, and on the third day in the second one. Surgery revealed a loose ileo-ileal invagination of 10 and 15 cm respectively, which was easily reduced. The postoperative course was uneventful in both cases. Although POI is a classical complication of abdominal surgery, it is often forgotten. In the cases described, the first surgical procedure combined most causative factors for POI: young age, preoperative chemotherapy, prolonged general anaesthesia, extensive retroperitoneal dissection close to components of the neurovegetative system. The use of opioids for postoperative analgesia may be an additional risk factor, as they alter intestinal motility. Epidural analgesia with local anaesthetics should be preferred in such cases.
ISSN:0750-7658