Intussusception in Neonates: Uncommon Causes and Diagnostic Dilemmas in Two Case Reports.

Abstract

Introduction: Neonatal intussusception (NI), although a rare cause of bowel obstruction, presents significant diagnostic challenges due to its clinical heterogeneity. This report describes two cases of NI, both presenting with vomiting and hematochezia. In both instances, the initial radiological evaluations led to a misdiagnosis, delaying timely treatment. Surgical intervention ultimately confirmed the diagnosis in both cases, highlighting the limitations of imaging modalities in neonates.

Case presentations: In the first case, a full-term female neonate presented with bilious vomiting and rectal bleeding on day one of life. Despite suspicion of an intestinal duplication on ultrasonography, the definitive diagnosis was made intraoperatively, where ileocecal intussusception and colonic duplication were identified. In the second case, a full-term male neonate exhibited similar symptoms but with signs suggestive of volvulus on imaging. Surgical exploration revealed an ileocolonic intussusception, which was reduced manually without ischemia or necrosis.

Conclusion: These cases emphasize the rarity of NI and the importance of considering it in differential diagnoses of neonates presenting with acute gastrointestinal symptoms, particularly when radiological findings are inconclusive. Timely surgical intervention remains critical for definitive diagnosis and optimal outcomes. Pediatric surgeons and clinicians must maintain a high index of suspicion for this rare condition to ensure timely diagnosis and minimize associated morbidity and mortality.