Rectosigmoid intussusception presenting as rectal prolapse in a premature baby: A case report

Introduction

Rectosigmoid intussusception in premature infants is a rare condition. We present a case of rectosigmoid intussusception initially presenting as rectal prolapse.

Case presentation

A premature male baby born at 24 weeks gestation was transferred to our center at two months of age due to recurrent rectal prolapse with minimal straining, despite repeated reductions. The etiology of the prolapse was unclear. An abdominal X-ray showed bowel dilation with air-fluid levels. The gas pattern in the abdomen indicated a mid to distal bowel obstruction. An abdominal ultrasound revealed an intussusception behind the bladder, measuring 3.8 cm in cranio-caudal dimension, appearing to be in the rectum or distal sigmoid colon. The patient underwent a diagnostic laparoscopy. We found a rectosigmoid intussusception, which we reduced laparoscopically. After the laparoscopy we did a flexible sigmoidoscopy and saw that the bowel wall appeared edematous and bruised but was not compromised. There were no polyps or any other intraluminal lesions. We concluded that the recurrent prolapse was the intussusception protruding through the anus (likely originating from mesenteric lymph nodes) rather than a rectal prolapse. There were no perioperative or postoperative complications, the patient tolerated the procedure well and had an uneventful recovery.

Conclusion

Rectosigmoid intussusception can resemble rectal prolapse and should be ruled out if prolapse recurs immediately after reduction.